Mozaic Therapeutic Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

MOZAIC THERAPEUTIC SERVICES

Practice address

6700 N Oracle Rd Ste 411
Tucson, AZ 85704-7734

Phone

(520) 891-2127

Fax

(520) 334-1428

NPI assigned

Mar 5, 2019

Organization subpart

No

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

Authorized official

Name

Adella Cordova

Title

Admin

Phone

(623) 326-1055

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551744000000",
    "number": "1164980678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 N ORACLE RD STE 411",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047734",
            "telephone_number": "520-891-2127",
            "fax_number": "520-334-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 N ORACLE RD STE 411",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857047734",
            "telephone_number": "520-891-2127",
            "fax_number": "520-334-1428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOZAIC THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-05",
        "last_updated": "2019-03-05",
        "status": "A",
        "authorized_official_last_name": "CORDOVA",
        "authorized_official_first_name": "ADELLA",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "623-326-1055"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12471861",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZLPC",
            "identifier": "14539",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Daniel Moyle, D.C.
• Kevin F Moynahan, MD
• Kevin Joseph Moynahan, MD
• Lisa Ann Moynihan, COTA/L
• Michael W Moynihan, MD
• Debra Gibbons Mozeleski, FNP
• Kimberlie Mozes, RNP
• MPL First Assisting
• Virginia Evelyn Mrizek, M.D.
• Kenneth Mroczek, PSYD

• Professional Counselor in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2019; 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.