Individual provider Active NPI

Joan Marie Moriarty, PH.D.

  • Clinical Psychologist
  • Birmingham, MI
National Provider Identifier
1508985276
Registry record updated Jan 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301002029 Issued in MI
Practice address
55 W Maple Rd
Suite 210
Birmingham, MI 48009-3303
Phone
(313) 562-0550
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 6301002029 MI
Clinical Child & Adolescent Psychologist 103TC2200X 6301002029 MI
Family Psychologist 103TF0000X 6301002029 MI
Clinical Psychologist 103TC0700X 6301002029 MI Primary

Addresses

Primary practice location

55 W Maple Rd
Suite 210
Birmingham, MI 48009-3303

Mailing address

280 W Maple Rd
Ste 219
Birmingham, MI 48009-3349
Phone (313) 562-0550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000589 MI Practitioner - Clinical Psychologist 2567658057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

280 W Maple Rd
Suite 219
Birmingham, MI 48009-3349
Phone (248) 646-3820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
6301002029MIMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
James Moriarty PHD & Joan Moriarty PHD PC Clinical CurrentSince Apr 9, 2010 Accepting new patients

Locations

55 W Maple Rd
Ste 210
Birmingham, MI 48009
Phone (248) 646-3820

280 W Maple Rd
Ste 219
Birmingham, MI 48009
Phone (248) 646-3820

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547942400000",
    "number": "1508985276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 W MAPLE RD",
            "address_2": "STE 219",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480093349",
            "telephone_number": "313-562-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W MAPLE RD",
            "address_2": "SUITE 210",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480093303",
            "telephone_number": "313-562-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIARTY",
        "first_name": "JOAN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2019-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MI",
            "license": "6301002029",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301002029",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MI",
            "license": "6301002029",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301002029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

Verify at the official NPI Registry.