Provider Demographics
NPI:1093065732
Name:GRIESHABER, KATHERINE S (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
Last Name:GRIESHABER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:STASTNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:360 OAK HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-5702
Mailing Address - Country:US
Mailing Address - Phone:985-726-9333
Mailing Address - Fax:
Practice Address - Street 1:1100 E JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043
Practice Address - Country:US
Practice Address - Phone:504-333-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA104011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical