1568548287 NPI number — MRS. KATHERINE A MCCURRY LCSW

Table of content: MRS. KATHERINE A MCCURRY LCSW (NPI 1568548287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568548287 NPI number — MRS. KATHERINE A MCCURRY LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCURRY
Provider First Name:
KATHERINE
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CASABELLA
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568548287
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25101 CHAGRIN BLVD
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
BEACHWOOD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44122-5643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-831-6611
Provider Business Mailing Address Fax Number:
216-456-8128

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 EXECUTIVE PARK
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40207-4201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-552-5068
Provider Business Practice Location Address Fax Number:
216-456-8128
Provider Enumeration Date:
10/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  KY2021 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: KY2021 . This is a "LCSW LICENSE #" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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