Moss, Ernest
Moss, Ernest is an individual health care provider with primary practice located at 1001 W Broadway Ste D Suite D, Farmington NM 87401-5638. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Moss, Ernest can be contacted via phone (505) 566-0339.Contact Information
Primary practice address
1001 W Broadway Ste D Suite D
Farmington NM 87401-5638
Phone: (505) 566-0339
Fax: (505) 325-9113
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 0132481 | New Mexico |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 712 | Montana |
Profile Details
| NPI number | 1316921471 |
|---|---|
| LBN Legal business name | Moss, Ernest |
| Credentials | M.S., LPCC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 2nd, 2005 |
| Last updated | Jan 27th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316921471 | NPPES |
| Texas | MEDICAID | 095721902 | |
| Texas | Other | 82421L |
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