Provider Demographics
NPI:1962424317
Name:MOSELEY, CYNTHIA HILL (LCSW)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:HILL
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW
Mailing Address - Street 1:4646 POPLAR AVE
Mailing Address - Street 2:SUITE 307
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-4426
Mailing Address - Country:US
Mailing Address - Phone:901-405-0990
Mailing Address - Fax:901-405-0993
Practice Address - Street 1:4646 POPLAR AVE
Practice Address - Street 2:SUITE 307
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4426
Practice Address - Country:US
Practice Address - Phone:901-405-0990
Practice Address - Fax:901-405-0993
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000009221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP38911Medicare UPIN