Provider Demographics
NPI:1114813086
Name:MORO, KATHLEEN (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:
Last Name:MORO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:SHEMANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:26 N SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-1834
Mailing Address - Country:US
Mailing Address - Phone:570-780-9872
Mailing Address - Fax:
Practice Address - Street 1:26 N SCOTT ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-1834
Practice Address - Country:US
Practice Address - Phone:570-780-9872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020479103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist