Active NPI
Taneisha Cherrelle Moss, MS, LPC, NCC
- Professional Counselor
- Stone Mountain, GA
National Provider Identifier
1619566767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 012145
- Practice address
- 6764 Blantyre Blvd
Stone Mountain, GA 30087-5482 - Phone
- (770) 712-8907
- NPI assigned
- Jan 13, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 012145 | GA | Primary |
Addresses
Primary practice location
6764 Blantyre Blvd
Stone Mountain, GA 30087-5482
Mailing address
341 Oaktown PL
Lawrenceville, GA 30044-3823
Phone (770) 712-8907
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012145 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631491200000",
"number": "1619566767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "341 OAKTOWN PL",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300443823",
"telephone_number": "770-712-8907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6764 BLANTYRE BLVD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300875482",
"telephone_number": "770-712-8907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "TANEISHA",
"middle_name": "CHERRELLE",
"name_prefix": "Ms.",
"credential": "MS, LPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-01-13",
"last_updated": "2021-09-13",
"certification_date": "2021-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "012145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.