Provider Demographics
NPI:1386915742
Name:MOSER, ASHLEY ELIZABETH (LMFT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:MOSER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:SHEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:6633 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3321
Mailing Address - Country:US
Mailing Address - Phone:704-366-1264
Mailing Address - Fax:704-442-4162
Practice Address - Street 1:6633 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3321
Practice Address - Country:US
Practice Address - Phone:704-366-1264
Practice Address - Fax:704-442-4162
Is Sole Proprietor?:No
Enumeration Date:2012-01-17
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1571106H00000X
IL166.000854106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1571OtherLMFT