Provider Demographics
NPI:1114373669
Name:PRINTUP, KATHRYN (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PRINTUP
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:SCHWAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:620 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-2319
Mailing Address - Country:US
Mailing Address - Phone:315-426-3600
Mailing Address - Fax:
Practice Address - Street 1:1330 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1173
Practice Address - Country:US
Practice Address - Phone:315-426-5950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 087690101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health