Individual provider Active NPI

Bridie Kaitlin Moriarty, NY

  • Psychologist
  • Great Neck, NY
National Provider Identifier
1780291369
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
027501 Issued in NY
Practice address
1010 Northern Blvd Ste 416
Great Neck, NY 11021-5330
Phone
(518) 487-7116
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 027501 NY Primary

Addresses

Primary practice location

1010 Northern Blvd Ste 416
Great Neck, NY 11021-5330

Mailing address

23 Schenck Ave Apt 2Ae
Great Neck, NY 11021-3621
Phone (203) 470-6479

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
027501NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Counseling Center Inc Mental Health PastSince Dec 17, 2024 Accepting new patients
North Shore Counseling Center Inc Mental Health PastSince Sep 21, 2025 Accepting new patients

Organizations & group practices 2

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1780291369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 SCHENCK AVE APT 2AE",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213621",
            "telephone_number": "203-470-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 NORTHERN BLVD STE 416",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215330",
            "telephone_number": "518-487-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIARTY",
        "first_name": "BRIDIE",
        "middle_name": "KAITLIN",
        "name_prefix": "Dr.",
        "credential": "NY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "027501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.