Provider Demographics
NPI:1265193619
Name:VORIS, KAITLIN T (LPC)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:T
Last Name:VORIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 COUNTY ROAD 521
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-4314
Mailing Address - Country:US
Mailing Address - Phone:973-903-2176
Mailing Address - Fax:
Practice Address - Street 1:350 SPARTA AVE STE C2A
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1123
Practice Address - Country:US
Practice Address - Phone:973-903-2176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00812600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional