Provider Demographics
NPI:1649544057
Name:MORRIS, KATHRYN ELIZABETH (PSYD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1372 N SUSQUEHANNA TRL
Mailing Address - Street 2:SUITE 330
Mailing Address - City:SELINSGROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17870-8971
Mailing Address - Country:US
Mailing Address - Phone:570-743-2323
Mailing Address - Fax:
Practice Address - Street 1:1372 N SUSQUEHANNA TRL
Practice Address - Street 2:SUITE 330
Practice Address - City:SELINSGROVE
Practice Address - State:PA
Practice Address - Zip Code:17870-8971
Practice Address - Country:US
Practice Address - Phone:570-743-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05018103TC1900X
WV1073103TC1900X
PAPS017859103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling