Provider Demographics
NPI:1023609542
Name:MOSCA, CHRISTOPHER WILLIAM (LMHC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WILLIAM
Last Name:MOSCA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 DENIM DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3624
Mailing Address - Country:US
Mailing Address - Phone:518-362-6861
Mailing Address - Fax:
Practice Address - Street 1:30 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-5142
Practice Address - Country:US
Practice Address - Phone:518-584-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09773101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY09773OtherLMHC