Individual provider Active NPI

Elizabeth Dugan Moran, LICSW

  • Mental Health Counselor
  • Boston, MA
National Provider Identifier
1033604400
Registry record updated Jun 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
116443 Issued in MA
Practice address
Emergency Department Admin, Dowling Building Room #1103
Boston Medical Center, 1 Boston Medical Center Place
Boston, MA 02188
Phone
(617) 414-4926
NPI assigned
Jun 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 116443 MA Primary

Addresses

Primary practice location

Emergency Department Admin, Dowling Building Room #1103
Boston Medical Center, 1 Boston Medical Center Place
Boston, MA 02188

Mailing address

Emergency Department Admin, Dowling Building Room #1103
Boston Medical Center, 1 Boston Medical Center Place
Boston, MA 02188
Phone (617) 414-4926

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

State licenses

LicenseStateTypeSpecialty
116443MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1033604400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EMERGENCY DEPARTMENT ADMIN, DOWLING BUILDING ROOM #1103",
            "address_2": "BOSTON MEDICAL CENTER, 1 BOSTON MEDICAL CENTER PLACE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02188",
            "telephone_number": "617-414-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EMERGENCY DEPARTMENT ADMIN, DOWLING BUILDING ROOM #1103",
            "address_2": "BOSTON MEDICAL CENTER, 1 BOSTON MEDICAL CENTER PLACE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02188",
            "telephone_number": "617-414-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAN MORAN",
        "first_name": "ELIZABETH",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "116443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.