Provider Demographics
NPI:1275562548
Name:MOSCINSKA, SHARA (LPCC)
Entity Type:Individual
Prefix:MS
First Name:SHARA
Middle Name:
Last Name:MOSCINSKA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:MOSCINSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC
Mailing Address - Street 1:5 PINE CT
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043-9131
Mailing Address - Country:US
Mailing Address - Phone:505-771-8242
Mailing Address - Fax:505-771-3438
Practice Address - Street 1:3 HOMESTEADS RD.
Practice Address - Street 2:SUITE E
Practice Address - City:PLACITAS
Practice Address - State:NM
Practice Address - Zip Code:87043
Practice Address - Country:US
Practice Address - Phone:505-385-1932
Practice Address - Fax:505-771-3438
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0105421101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional