Provider Demographics
NPI:1073970331
Name:LINNEMEYER, KATIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:
Last Name:LINNEMEYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1424 E SHERMAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-4045
Mailing Address - Country:US
Mailing Address - Phone:208-582-0588
Mailing Address - Fax:
Practice Address - Street 1:1424 E SHERMAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4045
Practice Address - Country:US
Practice Address - Phone:208-315-6537
Practice Address - Fax:208-215-6537
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-35016104100000X
IDLCSW-480941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker