Provider Demographics
NPI:1245603653
Name:MOSS, DAVID (LMHC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MOSS
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 SE 17TH ST STE 102
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-9109
Mailing Address - Country:US
Mailing Address - Phone:352-622-4488
Mailing Address - Fax:352-565-2196
Practice Address - Street 1:2303 SE 17TH ST STE 102
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-9109
Practice Address - Country:US
Practice Address - Phone:352-622-4488
Practice Address - Fax:352-565-2196
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-06
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health