Provider Demographics
NPI:1154079994
Name:MOTT, KATHERINE A (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:A
Last Name:MOTT
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 1:224 WESTON DR
Mailing Address - Street 2:
Mailing Address - City:WOOLWICH TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-2610
Mailing Address - Country:US
Mailing Address - Phone:609-222-0589
Mailing Address - Fax:
Practice Address - Street 1:224 WESTON DR
Practice Address - Street 2:
Practice Address - City:WOOLWICH TWP
Practice Address - State:NJ
Practice Address - Zip Code:08085-2610
Practice Address - Country:US
Practice Address - Phone:609-222-0589
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059162001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical