Provider Demographics
NPI:1740153360
Name:MORA, KAELYN
Entity type:Individual
Prefix:
First Name:KAELYN
Middle Name:
Last Name:MORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 KEISLER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-9307
Mailing Address - Country:US
Mailing Address - Phone:919-439-9323
Mailing Address - Fax:919-415-0450
Practice Address - Street 1:531 KEISLER DR STE 104
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-9307
Practice Address - Country:US
Practice Address - Phone:919-439-9323
Practice Address - Fax:919-415-0450
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP023083104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker