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NPI 1619462926

NPI 1619462926 : KRISTIN LAURA MORAN LCSW : HUNTSVILLE, AL

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General NPI Number Information
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    NPI Number           |    1619462926
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTIN LAURA MORAN LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/28/2018
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    Last Update Date     |    06/28/2018
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Provider Practice Location Address
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    Address Line         |    101 SIVLEY RD SW 
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    City                 |    HUNTSVILLE
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    State                |    AL
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    Zip                  |    35801-4470
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    Country              |    US
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    Telephone            |    256-265-2762
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    101 SIVLEY RD SW 
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    City                 |    HUNTSVILLE
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    State                |    AL
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    Zip                  |    35801-4470
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    Country              |    US
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    Telephone            |    256-265-2762
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    SW13625
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    License Number State |    FL
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Taxonomy #2
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    44SC05327200
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    License Number State |    NJ
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Taxonomy #3
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    2140G
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    License Number State |    AL
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