Healthcare Provider Details

I. General information

NPI: 1760853063
Provider Name (Legal Business Name): KATHERINE E MORTON PSYD, HSPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 ROSEBUD LN
NEWBURGH IN
47630-9332
US

IV. Provider business mailing address

5155 ROSEBUD LN
NEWBURGH IN
47630-9332
US

V. Phone/Fax

Practice location:
  • Phone: 812-773-8321
  • Fax: 812-961-6546
Mailing address:
  • Phone: 812-773-8321
  • Fax: 812-961-6546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number99069025A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: