Provider Demographics
NPI:1679782544
Name:MOROTTI, KATHLEEN (LPC, LCDAC, ADTR)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:MOROTTI
Suffix:
Gender:F
Credentials:LPC, LCDAC, ADTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 192
Mailing Address - Street 2:129 E. GERMAN ST
Mailing Address - City:SHEPHERDSTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25443-0192
Mailing Address - Country:US
Mailing Address - Phone:304-876-2770
Mailing Address - Fax:
Practice Address - Street 1:129 E. GERMAN ST
Practice Address - Street 2:
Practice Address - City:SHEPHERDSTOWN
Practice Address - State:WV
Practice Address - Zip Code:25443-0192
Practice Address - Country:US
Practice Address - Phone:304-876-2770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1569101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health