Sarah Anne Mossa

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180011720 Issued in IL

Practice address

1711 Saint Andrews Dr
Shiloh, IL 62269-2918

Phone

(618) 589-3799

Fax

(618) 589-3799

NPI assigned

Jan 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1831729763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1711 SAINT ANDREWS DR",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692918",
            "telephone_number": "618-589-3799",
            "fax_number": "618-589-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 SAINT ANDREWS DR",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622692918",
            "telephone_number": "618-589-3799",
            "fax_number": "618-589-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSSA",
        "first_name": "SARAH",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "MO",
            "license": "2008000925",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IL",
            "license": "178005110",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180011720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "14590295",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Shiloh, IL
• Providers in Shiloh, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.