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Individual

HAROLD PRENTICE MOSELEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW, LCSW, IMHP

Contact information

Practice address
6107 MAPLE ST, SUITE B, OMAHA, NE 68104-4001
(402) 740-6576
Mailing address
PO BOX 34280, OMAHA, NE 68134-0280
(402) 740-6576

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMHP #878
NE
1041C0700X
Clinical Social Worker
Primary
83
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
85362
BLUE CROSS BLUE SHIELD
NE
Enumeration date
12/07/2006
Last updated
03/23/2012
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