Individual provider Active NPI

Kathryn Elizabeth Moreno, LCAT

  • Psychoanalyst
  • Eastchester, NY
National Provider Identifier
1093346272
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychoanalystTaxonomy code 102L00000X
License
001221 Issued in NY
Practice address
434 White Plains Rd Ste 6
Eastchester, NY 10709-2828
Phone
(617) 510-0931
NPI assigned
Jan 28, 2020
Last updated
Jun 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH22366 FL
Art Therapist 221700000X 002432 NY
Psychoanalyst 102L00000X 001221 NY Primary

Addresses

Primary practice location

434 White Plains Rd Ste 6
Eastchester, NY 10709-2828

Mailing address

91 Lakeshore Dr
Eastchester, NY 10709-5214
Phone (617) 510-9031

Other practice location 1

245 E 13th St
New York, NY 10003-5641
Phone (212) 422-1221

Other practice location 2

91 Lakeshore Dr
Eastchester, NY 10709-5214
Phone (617) 510-9031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 7, 2025 through Mar 7, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH22366FLMDMental Health Counselor
001221NYMDPsychoanalyst

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1093346272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 LAKESHORE DR",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107095214",
            "telephone_number": "617-510-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 WHITE PLAINS RD STE 6",
            "city": "EASTCHESTER",
            "state": "NY",
            "postal_code": "107092828",
            "telephone_number": "617-510-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 E 13th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100035641",
            "country_code": "US",
            "telephone_number": "212-422-1221",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "91 Lakeshore Dr",
            "address_purpose": "LOCATION",
            "city": "Eastchester",
            "state": "NY",
            "postal_code": "107095214",
            "country_code": "US",
            "telephone_number": "617-510-9031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORENO",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "LCAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22366",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "002432",
            "primary": false
        },
        {
            "code": "102L00000X",
            "taxonomy_group": "",
            "desc": "Psychoanalyst",
            "state": "NY",
            "license": "001221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastchester, NY

Sources for this page

Verify at the official NPI Registry.