Provider Demographics
NPI:1336290279
Name:MORAN, KAY LYNNE (MSW, LCSW, CCM)
Entity Type:Individual
Prefix:MRS
First Name:KAY
Middle Name:LYNNE
Last Name:MORAN
Suffix:
Gender:F
Credentials:MSW, LCSW, CCM
Other - Prefix:MS
Other - First Name:KAY
Other - Middle Name:LYNNE
Other - Last Name:SCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:126 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425
Mailing Address - Country:US
Mailing Address - Phone:304-365-0254
Mailing Address - Fax:304-368-5346
Practice Address - Street 1:WELLSPRING FAMILY SERVICES
Practice Address - Street 2:827 FAIRMONT RD SUITE 201
Practice Address - City:WESTOVER
Practice Address - State:WV
Practice Address - Zip Code:26501
Practice Address - Country:US
Practice Address - Phone:304-292-1716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVCP009389271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0115071000Medicaid
WV0115071000Medicaid
WVP11813Medicare UPIN