Provider Demographics
NPI:1194375022
Name:MORATAYA, STEPHANIE (LPC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MORATAYA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 PENN AVENUE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3017
Mailing Address - Country:US
Mailing Address - Phone:484-513-3793
Mailing Address - Fax:484-509-5122
Practice Address - Street 1:932 PENN AVENUE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3017
Practice Address - Country:US
Practice Address - Phone:484-513-3793
Practice Address - Fax:484-509-5122
Is Sole Proprietor?:No
Enumeration Date:2019-09-12
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011308101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty