Active NPI
Jonathan Mossberg, LCSW
- Clinical Social Worker
- Allen, TX
National Provider Identifier
1700346012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 61862
- Practice address
- 1514 N Greenville Ave Ste 310
Allen, TX 75002-1205 - Phone
- (547) 131-8214
- NPI assigned
- Mar 22, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 61862 | TX | Primary |
Addresses
Primary practice location
1514 N Greenville Ave Ste 310
Allen, TX 75002-1205
Mailing address
400 W Pembroke Ave
Dallas, TX 75208-6534
Phone (914) 204-0238
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 61862 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553212800000",
"number": "1700346012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 W PEMBROKE AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752086534",
"telephone_number": "914-204-0238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1514 N GREENVILLE AVE STE 310",
"city": "ALLEN",
"state": "TX",
"postal_code": "750021205",
"telephone_number": "547-131-8214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSSBERG",
"first_name": "JONATHAN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-22",
"last_updated": "2019-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "61862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allen, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.