Provider Demographics
NPI:1346507449
Name:MOSS, LAURA B (LCSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:MOSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:B
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:9 CHERRY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1203
Mailing Address - Country:US
Mailing Address - Phone:732-306-9198
Mailing Address - Fax:609-371-1357
Practice Address - Street 1:9 CHERRY BROOK LN
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1203
Practice Address - Country:US
Practice Address - Phone:732-306-9198
Practice Address - Fax:609-371-1357
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC045305001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical