Provider Demographics
NPI:1457443616
Name:MOSDEN, PATRICIA W (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:W
Last Name:MOSDEN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 BANKS STONE DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-4856
Mailing Address - Country:US
Mailing Address - Phone:919-772-7300
Mailing Address - Fax:919-772-7300
Practice Address - Street 1:4016 BANKS STONE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-4856
Practice Address - Country:US
Practice Address - Phone:919-772-7300
Practice Address - Fax:919-772-7300
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0003961041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003085Medicaid