Provider Demographics
NPI:1306519087
Name:MORAN, JAMES RICHARD (LCMHCA)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:MORAN
Suffix:
Gender:M
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 KRAMER RD
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-8790
Mailing Address - Country:US
Mailing Address - Phone:910-514-8255
Mailing Address - Fax:
Practice Address - Street 1:605 W MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1693
Practice Address - Country:US
Practice Address - Phone:919-283-1274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health