Provider Demographics
NPI:1871890145
Name:MOSES, SAMUEL AUBREY (LCSW)
Entity type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:AUBREY
Last Name:MOSES
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 NE 191ST ST
Mailing Address - Street 2:H-211
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4093
Mailing Address - Country:US
Mailing Address - Phone:305-479-7575
Mailing Address - Fax:305-479-7575
Practice Address - Street 1:1101 NE 191 STREET
Practice Address - Street 2:H-211
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4093
Practice Address - Country:US
Practice Address - Phone:305-479-7575
Practice Address - Fax:305-479-7575
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-22
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW66391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical