Provider Demographics
NPI:1144508771
Name:MOSES, LYNN C (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:C
Last Name:MOSES
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:FORT TOTTEN, BUILDING 413
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11359
Mailing Address - Country:US
Mailing Address - Phone:718-352-2140
Mailing Address - Fax:718-352-2491
Practice Address - Street 1:FORT TOTTEN, BUILDING 413
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11359
Practice Address - Country:US
Practice Address - Phone:718-352-2140
Practice Address - Fax:718-352-2491
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0757701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical