Provider Demographics
NPI:1659097111
Name:MOSLEY, COURTNEY R (MS)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:R
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11439 NARROWLEAF DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-3614
Mailing Address - Country:US
Mailing Address - Phone:317-313-4268
Mailing Address - Fax:
Practice Address - Street 1:125 N SHORTRIDGE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4908
Practice Address - Country:US
Practice Address - Phone:317-241-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health