Provider Demographics
NPI:1982977716
Name:MACMORAN, KATHRYN TUTTLE (LPCA)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:TUTTLE
Last Name:MACMORAN
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 TURNBERRY CT
Mailing Address - Street 2:
Mailing Address - City:TRENT WOODS
Mailing Address - State:NC
Mailing Address - Zip Code:28562-7220
Mailing Address - Country:US
Mailing Address - Phone:610-529-4412
Mailing Address - Fax:
Practice Address - Street 1:110 TURNBERRY CT
Practice Address - Street 2:
Practice Address - City:TRENT WOODS
Practice Address - State:NC
Practice Address - Zip Code:28562-7220
Practice Address - Country:US
Practice Address - Phone:610-529-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8926101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional