Provider Demographics
NPI:1548149297
Name:MOSES, KARLA LYNETTE
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:LYNETTE
Last Name:MOSES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 W WALNUT ST APT 220
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18101-2270
Mailing Address - Country:US
Mailing Address - Phone:267-565-8337
Mailing Address - Fax:
Practice Address - Street 1:4905 W TILGHMAN ST STE 240
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9133
Practice Address - Country:US
Practice Address - Phone:610-880-8592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001655101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1770674053Medicaid