Lakevinya Moss
Individual provider Active NPI Social Worker · Gladewater, TX
NPI 1750089231 · NPPES record last updated Feb 23, 2023
Key facts
- NPI
- 1750089231
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 1017 Chevy Chase St
Gladewater, TX 75647-4103 - Phone
- (469) 647-8495
- NPI assigned
- Feb 23, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Yes |
Addresses
Primary practice location
1017 Chevy Chase St
Gladewater, TX 75647-4103
Mailing address
1017 Chevy Chase St
Gladewater, TX 75647-4103
Other providers in Gladewater, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.