Provider Demographics
NPI:1699959015
Name:MOSLEY, VELVET (LMSW)
Entity type:Individual
Prefix:MRS
First Name:VELVET
Middle Name:
Last Name:MOSLEY
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 1:30154 MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:NEW HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:48165-9203
Mailing Address - Country:US
Mailing Address - Phone:248-437-5903
Mailing Address - Fax:
Practice Address - Street 1:30154 MAGNOLIA DR
Practice Address - Street 2:N/A
Practice Address - City:NEW HUDSON
Practice Address - State:MI
Practice Address - Zip Code:48165-9203
Practice Address - Country:US
Practice Address - Phone:248-437-5903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010840831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical