Provider Demographics
NPI:1154782324
Name:MOSSBURG, EMILY J (MA, LMFT, CSAC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:J
Last Name:MOSSBURG
Suffix:
Gender:F
Credentials:MA, LMFT, CSAC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:M
Other - Last Name:BRANTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:67 E SHIRLEY AVE APT B
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186-3522
Mailing Address - Country:US
Mailing Address - Phone:571-248-1881
Mailing Address - Fax:
Practice Address - Street 1:67 E SHIRLEY AVE APT B
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3522
Practice Address - Country:US
Practice Address - Phone:571-248-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
VA071700187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)