Provider Demographics
NPI:1275858649
Name:JAMES MORIARTY PHD & JOAN MORIARTY PHD PC
Entity Type:Organization
Organization Name:JAMES MORIARTY PHD & JOAN MORIARTY PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORIARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-646-3820
Mailing Address - Street 1:55 W MAPLE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-3303
Mailing Address - Country:US
Mailing Address - Phone:248-646-3820
Mailing Address - Fax:
Practice Address - Street 1:55 W MAPLE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3303
Practice Address - Country:US
Practice Address - Phone:248-646-3820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty