Provider Demographics
NPI:1699117879
Name:MOSS, LINDSEY MEADOWS-RUSS (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:MEADOWS-RUSS
Last Name:MOSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 FREEDOM DR STE 7500
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-3490
Mailing Address - Country:US
Mailing Address - Phone:980-240-4378
Mailing Address - Fax:704-336-7112
Practice Address - Street 1:3205 FREEDOM DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-2866
Practice Address - Country:US
Practice Address - Phone:980-240-4378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0085141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical