Healthcare Provider Details

I. General information

NPI: 1548236458
Provider Name (Legal Business Name): HELEN TERESA MORAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 MONTGOMERY HWY SUITE 200
BIRMINGHAM AL
35216-2845
US

IV. Provider business mailing address

1025 MONTGOMERY HWY SUITE 200
BIRMINGHAM AL
35216-2845
US

V. Phone/Fax

Practice location:
  • Phone: 205-978-7511
  • Fax: 205-978-7277
Mailing address:
  • Phone: 205-978-7511
  • Fax: 205-978-7277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number00004339
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier4006421
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerAETNA
# 2
Identifier1585316
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerUNITED BEHAVIORAL HEALTH
# 3
Identifier51079074
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBLUE CROSS IN-STATE
# 4
Identifier721389024T5XH1W
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerMAGELLAN
# 5
Identifier123320
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerVALUE OPTIONS
# 6
Identifier51500269
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerBLUE CROSS OUT-OF-STATE
# 7
Identifier225693
Identifier TypeOTHER
Identifier StateAL
Identifier IssuerCOMPSY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: