Provider Demographics
NPI:1619848165
Name:MOSES, JAYMIE LENETTE (LMSW)
Entity type:Individual
Prefix:
First Name:JAYMIE
Middle Name:LENETTE
Last Name:MOSES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 225284
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-5284
Mailing Address - Country:US
Mailing Address - Phone:254-826-6303
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 225284
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75222-5284
Practice Address - Country:US
Practice Address - Phone:254-826-6303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114127104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker