Provider Demographics
NPI:1104952944
Name:MOSLEY, JOSEPH R (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:R
Last Name:MOSLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 NEW ROAD
Mailing Address - Street 2:CENTRAL SQUARE, UNIT 65
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221
Mailing Address - Country:US
Mailing Address - Phone:609-926-4644
Mailing Address - Fax:609-926-6855
Practice Address - Street 1:5215 WELLINGTON AVENUE SUITE 800
Practice Address - Street 2:
Practice Address - City:VENTNOR
Practice Address - State:NJ
Practice Address - Zip Code:08406
Practice Address - Country:US
Practice Address - Phone:609-926-4644
Practice Address - Fax:609-823-6433
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI 02498103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical