Provider Demographics
NPI:1558183913
Name:KEVIN MOSHIER LCSW LLC
Entity type:Organization
Organization Name:KEVIN MOSHIER LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOSHIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-837-7538
Mailing Address - Street 1:161 WESTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06798-2723
Mailing Address - Country:US
Mailing Address - Phone:203-837-7538
Mailing Address - Fax:410-861-6262
Practice Address - Street 1:39 SHERMAN HILL RD STE C101
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-3650
Practice Address - Country:US
Practice Address - Phone:203-837-7538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty