Provider Demographics
NPI:1043594310
Name:WU, KATHY (LGPC)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 EVANS ST
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2820
Mailing Address - Country:US
Mailing Address - Phone:301-750-4140
Mailing Address - Fax:
Practice Address - Street 1:17826 NEW HAMPSHIRE AVE
Practice Address - Street 2:
Practice Address - City:ASHTON
Practice Address - State:MD
Practice Address - Zip Code:20861-9781
Practice Address - Country:US
Practice Address - Phone:180-049-1536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor