Provider Demographics
NPI:1891934535
Name:MOSLEY, AMINAH KHADIJAH (LMSW)
Entity Type:Individual
Prefix:
First Name:AMINAH
Middle Name:KHADIJAH
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 E 46TH ST
Mailing Address - Street 2:SUITE D6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-4248
Mailing Address - Country:US
Mailing Address - Phone:347-879-0315
Mailing Address - Fax:
Practice Address - Street 1:428 E 46TH ST
Practice Address - Street 2:SUITE D6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-4248
Practice Address - Country:US
Practice Address - Phone:347-879-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078071104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker