Provider Demographics
NPI:1811703879
Name:MORIARTY, ELISE (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:MORIARTY
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 APPLETON ST
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-3210
Mailing Address - Country:US
Mailing Address - Phone:413-540-9881
Mailing Address - Fax:413-540-9882
Practice Address - Street 1:507 APPLETON ST
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-3210
Practice Address - Country:US
Practice Address - Phone:413-540-9881
Practice Address - Fax:413-540-9882
Is Sole Proprietor?:No
Enumeration Date:2024-12-05
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker