Provider Demographics
NPI:1942019922
Name:MOSES, CASSIDY MARISA (LCMHCA)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:MARISA
Last Name:MOSES
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 E BROOKLYN VILLAGE AVE APT 348
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2998
Mailing Address - Country:US
Mailing Address - Phone:805-975-5087
Mailing Address - Fax:
Practice Address - Street 1:41 CLAYTON ST # 300
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2423
Practice Address - Country:US
Practice Address - Phone:828-658-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA20401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health