Active NPI
Chad Mosher
- Clinical Psychologist
- Tucson, AZ
National Provider Identifier
1053801316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4959
- Practice address
- 4646 E Fort Lowell Rd
Tucson, AZ 85712-1100 - Phone
- (520) 704-7056
- NPI assigned
- May 12, 2018
- Last updated
- Nov 19, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 14311 | AZ | |
| Clinical Psychologist | 103TC0700X | 4959 | AZ | Primary |
Addresses
Primary practice location
4646 E Fort Lowell Rd
Tucson, AZ 85712-1100
Mailing address
4646 E Fort Lowell Rd
Tucson, AZ 85712-1100
Phone (520) 704-7056
Other practice location 1
2695 N Craycroft Rd
Tucson, AZ 85712-2243
Phone (520) 322-2888
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14311 | AZ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creosote Mental Health Group | Mental Health | Current | Accepting new patients |
| A Place to Talk, PLLC | Current | Accepting new patients |
Locations
4626 E Fort Lowell Rd
Ste R
Tucson, AZ 85712
Phone (520) 375-9039
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tucson, AZ
- NPI 1841901451
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605744000000",
"number": "1053801316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4646 E FORT LOWELL RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857121100",
"telephone_number": "520-704-7056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4646 E FORT LOWELL RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857121100",
"telephone_number": "520-704-7056"
}
],
"practiceLocations": [
{
"address_1": "2695 N Craycroft Rd",
"address_purpose": "LOCATION",
"city": "Tucson",
"state": "AZ",
"postal_code": "857122243",
"country_code": "US",
"telephone_number": "520-322-2888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOSHER",
"first_name": "CHAD",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-12",
"last_updated": "2020-11-19",
"certification_date": "2020-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "14311",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "4959",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.