Provider Demographics
NPI:1609664317
Name:MOSLEY, STEPHANIE DESHAUN (ALC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DESHAUN
Last Name:MOSLEY
Suffix:
Gender:
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8089 HIGHWAY 72 W STE D
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9531
Mailing Address - Country:US
Mailing Address - Phone:256-325-0424
Mailing Address - Fax:256-325-0429
Practice Address - Street 1:8089 HIGHWAY 72 W STE D
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9531
Practice Address - Country:US
Practice Address - Phone:256-325-0424
Practice Address - Fax:256-325-0429
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health