Provider Demographics
NPI:1194577064
Name:MOSELEY, JASMIN J (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JASMIN
Middle Name:J
Last Name:MOSELEY
Suffix:
Gender:
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N TRYON ST STE 600
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28246-0100
Mailing Address - Country:US
Mailing Address - Phone:443-629-2375
Mailing Address - Fax:
Practice Address - Street 1:101 N TRYON ST STE 600
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28246-0100
Practice Address - Country:US
Practice Address - Phone:443-629-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-03
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD274891041C0700X
NCC0181111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical