Provider Demographics
NPI:1043457765
Name:MORIARTY-PUGGI, MARIE CHRISTINE (MA, LAPC)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:CHRISTINE
Last Name:MORIARTY-PUGGI
Suffix:
Gender:F
Credentials:MA, LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 WALNUT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3402
Mailing Address - Country:US
Mailing Address - Phone:617-379-0496
Mailing Address - Fax:617-379-0496
Practice Address - Street 1:543 NORTH ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2766
Practice Address - Country:US
Practice Address - Phone:508-984-5566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-16
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000651101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional