Provider Demographics
NPI:1801446125
Name:MOORADIAN, MICHAEL S (CDCII, CDCS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:S
Last Name:MOORADIAN
Suffix:
Gender:M
Credentials:CDCII, CDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 SAN JERONIMO DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2870
Mailing Address - Country:US
Mailing Address - Phone:907-830-2318
Mailing Address - Fax:
Practice Address - Street 1:30881 EKLUTNA LAKE RD
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-5166
Practice Address - Country:US
Practice Address - Phone:907-793-3120
Practice Address - Fax:907-688-1770
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3254101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)