Provider Demographics
NPI:1730595000
Name:MOSLEY, JULIE ANN (LPCC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:MOSLEY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10100 ELIDA RD
Mailing Address - Street 2:
Mailing Address - City:DELPHOS
Mailing Address - State:OH
Mailing Address - Zip Code:45833-9058
Mailing Address - Country:US
Mailing Address - Phone:859-341-9333
Mailing Address - Fax:
Practice Address - Street 1:1 MOOCK RD STE 101
Practice Address - Street 2:
Practice Address - City:WILDER
Practice Address - State:KY
Practice Address - Zip Code:41071-5465
Practice Address - Country:US
Practice Address - Phone:859-341-9333
Practice Address - Fax:859-341-9444
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY242058101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100579510Medicaid
KY242058OtherKENTUCKY BOARD OF LICENSED PROFESSIONAL COUNSELORS