MEDICARE: KATHY MOORE TRANSFORMING LIVES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1265242309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHY MOORE TRANSFORMING LIVES

Provider Business Mailing Address
First Line	:	665 PHILADELPHIA ST
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3941
Country	:	US
Telephone Number	:	412-600-0863
Fax Number	:

Provider Business Practice Location Address
First Line	:	665 PHILADELPHIA ST
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3941
Country	:	US
Telephone Number	:	412-600-0863
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	KATHLEEN MORELAND
Credential	:
Telephone Number	:	412-600-0863

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	01/10/2025

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