Provider Demographics
NPI:1265066674
Name:MORAN, MARGARET KAREN (LADAC II, NCAC II)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:KAREN
Last Name:MORAN
Suffix:
Gender:F
Credentials:LADAC II, NCAC II
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LADAC II, NCAC II
Mailing Address - Street 1:607 GLENN CIR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2212
Mailing Address - Country:US
Mailing Address - Phone:615-308-9385
Mailing Address - Fax:
Practice Address - Street 1:45A RUTLEDGE ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37210-2042
Practice Address - Country:US
Practice Address - Phone:615-308-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN877101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty