Provider Demographics
NPI:1669666566
Name:MOSES, CYNTHIA RAE (LSCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:RAE
Last Name:MOSES
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 S 18TH ST
Mailing Address - Street 2:SUITE 222
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-5642
Mailing Address - Country:US
Mailing Address - Phone:913-766-4206
Mailing Address - Fax:913-766-4210
Practice Address - Street 1:155 S 18TH ST
Practice Address - Street 2:SUITE 222
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-5642
Practice Address - Country:US
Practice Address - Phone:913-766-4206
Practice Address - Fax:913-766-4210
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1887101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health