Provider Demographics
NPI:1932790821
Name:MORRA, STEPHANIE E (LPC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:E
Last Name:MORRA
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 1:11 BOSS AVE
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-2705
Mailing Address - Country:US
Mailing Address - Phone:203-520-1276
Mailing Address - Fax:
Practice Address - Street 1:945 SOUTH AVE
Practice Address - Street 2:
Practice Address - City:CUSTER CITY
Practice Address - State:PA
Practice Address - Zip Code:16725-1672
Practice Address - Country:US
Practice Address - Phone:814-817-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC012017OtherBPOA