Provider Demographics
NPI:1114283017
Name:LINDA MOSBY, MA, LPCMH, LLC
Entity Type:Organization
Organization Name:LINDA MOSBY, MA, LPCMH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOSBY
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:484-883-6054
Mailing Address - Street 1:3522 SILVERSIDE RD., SUITE 32
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810
Mailing Address - Country:US
Mailing Address - Phone:484-883-6054
Mailing Address - Fax:
Practice Address - Street 1:3522 SILVERSIDE RD STE 32
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4911
Practice Address - Country:US
Practice Address - Phone:484-883-6054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty