Individual
JOHN MOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC, CODP, QMHP
Contact information
Practice address
1320 UNION ST, MORRIS, IL 60450-2426
(815) 941-3142
Mailing address
1148 COUNTY ROAD 27, MOUNTAIN HOME, AR 72653-7948
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
34538
IL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/10/2008
Last updated
08/21/2019
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