Provider Demographics
NPI:1134485188
Name:MOSLEY, CIJI R (LICSW)
Entity Type:Individual
Prefix:MS
First Name:CIJI
Middle Name:R
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 W COLLEGE ST
Mailing Address - Street 2:P O BOX 941
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5313
Mailing Address - Country:US
Mailing Address - Phone:256-764-3431
Mailing Address - Fax:256-768-7462
Practice Address - Street 1:635 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5313
Practice Address - Country:US
Practice Address - Phone:256-764-3431
Practice Address - Fax:256-768-7462
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2743G101YA0400X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)