Provider Demographics
NPI:1902400807
Name:MORIARTY, MICHAEL D (LPC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:MORIARTY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 ROUSER RD
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-6801
Mailing Address - Country:US
Mailing Address - Phone:412-604-8900
Mailing Address - Fax:412-299-8755
Practice Address - Street 1:105 BRADFORD RD STE 100
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-6920
Practice Address - Country:US
Practice Address - Phone:724-776-4844
Practice Address - Fax:724-776-0860
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012797101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional