Individual provider Active NPI

Ciji R Mosley, LICSW

  • Clinical Social Worker
  • Florence, AL
National Provider Identifier
1134485188
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2743G Issued in AL
Practice address
635 W College St
Florence, AL 35630-5313
Phone
(256) 764-3431
Fax
(256) 768-7462
NPI assigned
Apr 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 2743G AL
Clinical Social Worker 1041C0700X 2743G AL Primary

Addresses

Primary practice location

635 W College St
Florence, AL 35630-5313

Mailing address

635 W College St
P O Box 941
Florence, AL 35630-5313
Phone (256) 764-3431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150702000178 AL Practitioner - Clinical Social Worker 0547572646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Center for Mental HealthGroup PAC ID 6507821048, 15 clinicians

Practice addresses (Care Compare)

205 Jackson Ave S
Russellville, AL 35653-2233
Phone (256) 332-3971

635 College St W
Florence, AL 35631-5313
Phone (256) 764-3431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2743GALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Center for Mental Health CurrentSince May 3, 2015 Accepting new patients

Locations

635 W College St
Florence, AL 35630
Phone (256) 764-3431

205 Jackson Ave S
Russellville, AL 35653
Phone (256) 332-3971

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1134485188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 W COLLEGE ST",
            "address_2": "P O BOX 941",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305313",
            "telephone_number": "256-764-3431",
            "fax_number": "256-768-7462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 W COLLEGE ST",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356305313",
            "telephone_number": "256-764-3431",
            "fax_number": "256-768-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "CIJI",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2021-09-30",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AL",
            "license": "2743G",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2743G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

Verify at the official NPI Registry.