Provider Demographics
NPI:1255037867
Name:MOSCA, DAVID (LCMHCA, NCC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:MOSCA
Suffix:
Gender:M
Credentials:LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 MCCRIMMON PKWY APT 2209
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-4927
Mailing Address - Country:US
Mailing Address - Phone:609-203-0982
Mailing Address - Fax:
Practice Address - Street 1:5720 CREEDMOOR RD STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-2383
Practice Address - Country:US
Practice Address - Phone:919-977-6018
Practice Address - Fax:919-300-7471
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18486101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health