Provider Demographics
NPI:1588277545
Name:MOSS COUNSELING SERVICES
Entity type:Organization
Organization Name:MOSS COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MARRIAGE AND FAMILY THERAPIS
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:904-612-2243
Mailing Address - Street 1:12629 STEEPLECHASE LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-3506
Mailing Address - Country:US
Mailing Address - Phone:904-612-2243
Mailing Address - Fax:904-212-5204
Practice Address - Street 1:12629 STEEPLECHASE LN
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32223-3506
Practice Address - Country:US
Practice Address - Phone:904-612-2243
Practice Address - Fax:904-212-5204
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPHINE G MOSS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health