Provider Demographics
NPI:1609506377
Name:YOST, MOESHA BERNICE ANN
Entity Type:Individual
Prefix:
First Name:MOESHA
Middle Name:BERNICE ANN
Last Name:YOST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MOESHA
Other - Middle Name:BERNICE ANN
Other - Last Name:GODWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 CARRICK AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15210-4323
Mailing Address - Country:US
Mailing Address - Phone:347-612-5503
Mailing Address - Fax:
Practice Address - Street 1:810 CLAIRTON BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-5505
Practice Address - Country:US
Practice Address - Phone:347-612-5503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW138728104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker