Wendell Demarr Moss, M.A.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH60473731 Issued in WA

Practice address

1622 3Rd St
Marysville, WA 98270-5004

Phone

(425) 224-6693

NPI assigned

Jun 16, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1033590955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 RUCKER AVE APT 9",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012783",
            "telephone_number": "425-224-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 3RD ST",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982705004",
            "telephone_number": "425-224-6693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "WENDELL",
        "middle_name": "DEMARR",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-16",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH60473731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Marysville, WA
• Providers in Marysville, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.