Provider Demographics
NPI:1477989630
Name:MOORE, KATHRYN MCCARTER (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:MCCARTER
Last Name:MOORE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:NICOLE
Other - Last Name:MCCARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2520 ROBINHOOD ST
Mailing Address - Street 2:#1007
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2547
Mailing Address - Country:US
Mailing Address - Phone:512-217-1985
Mailing Address - Fax:
Practice Address - Street 1:2520 ROBINHOOD ST
Practice Address - Street 2:#1007
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2547
Practice Address - Country:US
Practice Address - Phone:512-217-1985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX57415104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker