| William A. Moss, Psy.d., Llc | |
|
2525 W Main St Ste 216 Rapid City SD 57702-2439 | |
| (605) 645-0371 | |
| Not Available |
| Full Name | William A. Moss, Psy.d., Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2525 W Main St Ste 216, Rapid City, South Dakota |
| Authorized Official Name and Position | William A Moss (PROPRIETOR) |
| Authorized Official Contact | 6056450371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| William A. Moss, Psy.d., Llc 2525 W Main St Ste 216 Rapid City SD 57702-2439 Ph: (605) 645-0371 | William A. Moss, Psy.d., Llc 2525 W Main St Ste 216 Rapid City SD 57702-2439 Ph: (605) 645-0371 |
| NPI Number | 1033255146 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 02/15/2022 |
| Certification Date | 02/15/2022 |
| Medicare PECOS PAC ID | 4880782333 |
|---|---|
| Medicare Enrollment ID | O20071116000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033255146 | NPI | - | NPPES |
| 6551862 | Medicaid | SD | |
| 1629048483 | Other | SD | NPI NUMBER (OLD) |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 416 (South Dakota) | Primary |
| Provider Name | William A Moss |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629048483 PECOS PAC ID: 0840250668 Enrollment ID: I20041015000757 |
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