Provider Demographics
NPI:1376952671
Name:KERNS, CONNOR MORROW (PHD)
Entity Type:Individual
Prefix:
First Name:CONNOR
Middle Name:MORROW
Last Name:KERNS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:CONNOR
Other - Middle Name:MORROW
Other - Last Name:PULEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:800 SPRUCE ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-6130
Mailing Address - Country:US
Mailing Address - Phone:215-829-3474
Mailing Address - Fax:215-829-5456
Practice Address - Street 1:800 SPRUCE ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-6130
Practice Address - Country:US
Practice Address - Phone:215-829-3474
Practice Address - Fax:215-829-5456
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017927103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical