Active NPI
Sara Elizabeth Moran, ATR-BC, LCAT, LADC-I
- Art Therapist
- Eastham, MA
National Provider Identifier
1245540855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Art Therapist
- License
- 001268-1
- Practice address
- 4205 State Hwy
Eastham, MA 02642-2165 - Phone
- (203) 807-1617
- NPI assigned
- Oct 15, 2010
- Last updated
- Feb 25, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 18280 | MA | |
| Art Therapist | 221700000X | 001268-1 | NY | Primary |
Addresses
Primary practice location
4205 State Hwy
Eastham, MA 02642-2165
Mailing address
PO Box 888
East Orleans, MA 02643-0888
Phone (203) 807-1617
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
| License | State | Type | Specialty |
|---|---|---|---|
| 18280 | MA | MD | Dentist |
| 001268-1 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582588800000",
"number": "1245540855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 888",
"city": "EAST ORLEANS",
"state": "MA",
"postal_code": "026430888",
"telephone_number": "203-807-1617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4205 STATE HWY",
"city": "EASTHAM",
"state": "MA",
"postal_code": "026422165",
"telephone_number": "203-807-1617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "SARA",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "ATR-BC, LCAT, LADC-I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2020-02-25",
"certification_date": "2020-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": "18280",
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": "NY",
"license": "001268-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.