Provider Demographics
NPI:1396274437
Name:MOSS, LAUREN JEANNE (LPC, PHD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:JEANNE
Last Name:MOSS
Suffix:
Gender:F
Credentials:LPC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 OLD SWEDE RD
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-9661
Mailing Address - Country:US
Mailing Address - Phone:484-889-6505
Mailing Address - Fax:
Practice Address - Street 1:676 OLD SWEDE RD
Practice Address - Street 2:
Practice Address - City:DOUGLASSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19518-9661
Practice Address - Country:US
Practice Address - Phone:484-889-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009383101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional