Shahrzad Moradi, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PY12320 Issued in FL

Practice address

11310 Legacy Ave
Palm Beach Gardens, FL 33410-3658

Phone

(305) 669-6503

NPI assigned

May 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nationwide Children's Hospital

  • Dental Clinic/Center
  • Columbus, OH
  • NPI 1407013964
  NPD (past)
• Ohio University Psychology and Social Work Clinic

  • Clinical Psychologist
  • Athens, OH
  • NPI 1972723971
  NPD (past)

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1144712555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11310 LEGACY AVE",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103658",
            "telephone_number": "305-669-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11310 LEGACY AVE",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103658",
            "telephone_number": "305-669-6503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORADI",
        "first_name": "SHAHRZAD",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "FL",
            "license": "PY12320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy R. Mooney, M.A.
• Camry Patrice Moore, MSW, RSCWI
• Grace Moore
• Brandon Jaquez Moorison
• Fernando Mora, M.D.
• Hadassah Zoe Morales
• Alexandra Morani
• Sahara Daniela Moreno
• Wendy Paola Moreno
• Lindsay Moretz, PTA

• Clinical Child & Adolescent Psychologist in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Clinical Child & Adolescent Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.