Provider Demographics
NPI:1073538815
Name:RINGHAM, KATHRYN MCCOY (LICSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MCCOY
Last Name:RINGHAM
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:GWEN
Other - Last Name:MCCOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:2312 S 6TH ST
Mailing Address - Street 2:SUITE F275
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1336
Mailing Address - Country:US
Mailing Address - Phone:612-273-8700
Mailing Address - Fax:612-273-9779
Practice Address - Street 1:2312 S 6TH ST
Practice Address - Street 2:SUITE F275
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1336
Practice Address - Country:US
Practice Address - Phone:612-273-8700
Practice Address - Fax:612-273-9779
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN050251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical