Individual provider Active NPI

Kathleen Hariett Moran, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1750669867
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081197 Issued in NY
Practice address
7423 Ridge Blvd Apt 6G
Brooklyn, NY 11209-2345
Phone
(917) 620-7212
NPI assigned
Jul 25, 2011
Last updated
Jun 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 081197 NY Primary

Addresses

Primary practice location

7423 Ridge Blvd Apt 6G
Brooklyn, NY 11209-2345

Mailing address

7423 Ridge Blvd Apt 6G
Brooklyn, NY 11209-2345
Phone (917) 620-7212

Other practice location 1

45 E 20th St Fl 6
New York, NY 10003-1308
Phone (917) 620-7212

Other names 1

  • Ms. Kathleen Hariett Dimuzio Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: No
  • 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
I20250530001683 NY Practitioner - Clinical Social Worker 4284143413 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Octave Psychiatry Behavioral Health PC CurrentSince Apr 6, 2025 Accepting new patients
Octave Psychiatry Behavioral Health PC CurrentSince Apr 6, 2025 Accepting new patients
Octave Behavioral Health PC Past Accepting new patients

Locations

286 Madison Ave
Fl 22
New York, NY 10017
Phone (914) 481-3109

45 E 20th St
Fl 6
New York, NY 10003
Phone (904) 404-5400

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1750669867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7423 RIDGE BLVD APT 6G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092345",
            "telephone_number": "917-620-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7423 RIDGE BLVD APT 6G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112092345",
            "telephone_number": "917-620-7212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 E 20th St Fl 6",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100031308",
            "country_code": "US",
            "telephone_number": "917-620-7212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "KATHLEEN",
        "middle_name": "HARIETT",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DIMUZIO",
            "middle_name": "HARIETT",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.