Provider Demographics
NPI:1457983199
Name:KERR, KATELYN ALYSE (MA, NCC)
Entity Type:Individual
Prefix:MRS
First Name:KATELYN
Middle Name:ALYSE
Last Name:KERR
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:MISS
Other - First Name:KATELYN
Other - Middle Name:ALYSE
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA NCC
Mailing Address - Street 1:793 OLD ROUTE 119 HWY NORTH
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701
Mailing Address - Country:US
Mailing Address - Phone:724-465-5576
Mailing Address - Fax:
Practice Address - Street 1:793 OLD ROUTE 119 HWY NORTH
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701
Practice Address - Country:US
Practice Address - Phone:724-465-5576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health