Provider Demographics
NPI:1144474875
Name:MORIARTY, CAROLYN FAY (LCSW)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:FAY
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4964 POINT PLEASANT PIKE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902-9500
Mailing Address - Country:US
Mailing Address - Phone:267-250-2412
Mailing Address - Fax:
Practice Address - Street 1:708 N SHADY RETREAT RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2503
Practice Address - Country:US
Practice Address - Phone:215-345-0551
Practice Address - Fax:215-345-0552
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW012990L104100000X
PACW0163811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker