Healthcare Provider Details

I. General information

NPI: 1801112545
Provider Name (Legal Business Name): MICHELE GREENE MORIARITY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 04/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 WISCONSIN AVE NW
WASHINGTON DC
20016-4119
US

IV. Provider business mailing address

5100 WISCONSIN AVE NW
WASHINGTON DC
20016-4119
US

V. Phone/Fax

Practice location:
  • Phone: 202-244-8855
  • Fax: 202-244-8856
Mailing address:
  • Phone: 202-244-8855
  • Fax: 202-244-8856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC14069
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: