1285837898 NPI number — MRS. KATHERINE CONE PODLISKA LCSW

Table of content: MRS. KATHERINE CONE PODLISKA LCSW (NPI 1285837898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285837898 NPI number — MRS. KATHERINE CONE PODLISKA LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PODLISKA
Provider First Name:
KATHERINE
Provider Middle Name:
CONE
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:
CONE
Provider Other First Name:
KATHERINE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285837898
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CMR 480, BOX 997
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AE
Provider Business Mailing Address Postal Code:
09128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GEB 2996 PANZER KASERNE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOEBLINGEN
Provider Business Practice Location Address State Name:
GERMANY
Provider Business Practice Location Address Postal Code:
71032
Provider Business Practice Location Address Country Code:
DE
Provider Business Practice Location Address Telephone Number:
07031152676
Provider Business Practice Location Address Fax Number:
07031152967
Provider Enumeration Date:
06/10/2007

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:  40936 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 12296 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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