Provider Demographics
NPI:1649546565
Name:MOSER, JULIE A (LPCC, LMHC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:MOSER
Suffix:
Gender:F
Credentials:LPCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2569
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98213-0569
Mailing Address - Country:US
Mailing Address - Phone:425-493-5803
Mailing Address - Fax:425-493-5801
Practice Address - Street 1:1520 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-1700
Practice Address - Country:US
Practice Address - Phone:425-493-5803
Practice Address - Fax:425-493-5801
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-25
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE 0700028101YP2500X
WALH 60300769101YM0800X
WALH60300769101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor