Provider Demographics
NPI:1750600680
Name:MOSS, NANCY ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ANN
Last Name:MOSS
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 1:18697 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4363
Mailing Address - Country:US
Mailing Address - Phone:434-239-0003
Mailing Address - Fax:434-239-0181
Practice Address - Street 1:150 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2823
Practice Address - Country:US
Practice Address - Phone:434-239-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional