Provider Demographics
NPI:1861705949
Name:MOSLEY-BOYD, JANICE LYNN (LMSW)
Entity type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LYNN
Last Name:MOSLEY-BOYD
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 1:101 FOX CHAPEL DR
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8372
Mailing Address - Country:US
Mailing Address - Phone:803-781-2356
Mailing Address - Fax:
Practice Address - Street 1:101 FOX CHAPEL DR
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8372
Practice Address - Country:US
Practice Address - Phone:803-781-2356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5298104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker