Individual provider Active NPI

Michael Herbert Moran, MA

  • Clinical Psychologist
  • Altoona, PA
National Provider Identifier
1033263777
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS004234L Issued in PA
Practice address
620 Howard Avenue
Altoona Regional Health Systems BHS
Altoona, PA 16601-4804
Phone
(814) 889-2141
Fax
(814) 889-7999
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS004234L PA Primary

Addresses

Primary practice location

620 Howard Avenue
Altoona Regional Health Systems BHS
Altoona, PA 16601-4804

Mailing address

620 Howard Avenue
Altoona, PA 16601-4804
Phone (814) 889-2141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
PS004234LPAMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033263777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 HOWARD AVENUE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014804",
            "telephone_number": "814-889-2141",
            "fax_number": "814-889-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 HOWARD AVENUE",
            "address_2": "ALTOONA REGIONAL HEALTH SYSTEMS BHS",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166014804",
            "telephone_number": "814-889-2141",
            "fax_number": "814-889-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "MICHAEL",
        "middle_name": "HERBERT",
        "name_prefix": "Mr.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS004234L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.