Provider Demographics
NPI:1750647475
Name:MOSBY, DELTON LIONEL (MSW, MPH, CDP)
Entity Type:Individual
Prefix:MR
First Name:DELTON
Middle Name:LIONEL
Last Name:MOSBY
Suffix:
Gender:M
Credentials:MSW, MPH, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1116 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2831
Mailing Address - Country:US
Mailing Address - Phone:206-726-4100
Mailing Address - Fax:206-328-3757
Practice Address - Street 1:1901 MARTIN LUTHER KING JR WAY S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4801
Practice Address - Country:US
Practice Address - Phone:206-322-7676
Practice Address - Fax:206-725-7585
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP0006102101YA0400X
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health