Provider Demographics
NPI:1164066882
Name:KATHERINE KOSMA SCHWARTZ LCSW LAC LLC
Entity Type:Organization
Organization Name:KATHERINE KOSMA SCHWARTZ LCSW LAC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:KOSMA
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LAC
Authorized Official - Phone:406-370-4179
Mailing Address - Street 1:2809 GREAT NORTHERN LOOP STE 300
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1749
Mailing Address - Country:US
Mailing Address - Phone:406-370-4179
Mailing Address - Fax:406-630-4002
Practice Address - Street 1:2809 GREAT NORTHERN LOOP STE 300
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1749
Practice Address - Country:US
Practice Address - Phone:406-370-4179
Practice Address - Fax:406-630-4002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty