Active NPI
Doug Moser, M.A., L.L.P.
- Health Psychologist
- Traverse City, MI
National Provider Identifier
1861687642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Psychologist
- License
- L1152057
- Practice address
- 1105 6TH St
Traverse City, MI 49684-2345 - Phone
- (231) 935-6461
- Fax
- (231) 935-6920
- NPI assigned
- Sep 13, 2007
- 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 |
|---|---|---|---|---|
| Health Psychologist | 103TH0004X | L1152057 | MI | Primary |
Addresses
Primary practice location
1105 6TH St
Traverse City, MI 49684-2345
Mailing address
230 W 16TH St
Traverse City, MI 49684-4120
Phone (231) 946-7930
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L1152057 | MI | MD | Health Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189641600000",
"number": "1861687642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "230 W 16TH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496844120",
"telephone_number": "231-946-7930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 6TH ST",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496842345",
"telephone_number": "231-935-6461",
"fax_number": "231-935-6920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSER",
"first_name": "DOUG",
"credential": "M.A., L.L.P.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-13",
"last_updated": "2007-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "MI",
"license": "L1152057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.