Provider Demographics
NPI:1740861137
Name:MOSSLEHI, DONNA (LPC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MOSSLEHI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ALEXANDRIA CT
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07424-3410
Mailing Address - Country:US
Mailing Address - Phone:973-941-8228
Mailing Address - Fax:
Practice Address - Street 1:30 ALEXANDRIA CT
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07424-3410
Practice Address - Country:US
Practice Address - Phone:973-941-8228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00748600101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health