Provider Demographics
NPI:1518606300
Name:MOSELEY, TAMARA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:
Last Name:MOSELEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 ELTINGVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-2110
Mailing Address - Country:US
Mailing Address - Phone:917-703-1263
Mailing Address - Fax:
Practice Address - Street 1:38 WINTHROP PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3043
Practice Address - Country:US
Practice Address - Phone:718-727-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty