Provider Demographics
NPI:1073952628
Name:MOSAAD, ALICEN L (MA, LPC, ACS)
Entity Type:Individual
Prefix:
First Name:ALICEN
Middle Name:L
Last Name:MOSAAD
Suffix:
Gender:F
Credentials:MA, LPC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 WILTSIE CT
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2974
Mailing Address - Country:US
Mailing Address - Phone:586-557-9506
Mailing Address - Fax:
Practice Address - Street 1:222 WILTSIE CT
Practice Address - Street 2:
Practice Address - City:WYCKOFF
Practice Address - State:NJ
Practice Address - Zip Code:07481-2974
Practice Address - Country:US
Practice Address - Phone:586-557-9506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013695101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional