Provider Demographics
NPI:1205387313
Name:HARNESS, KATHY (CSW)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:HARNESS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 S HIGHWAY 27
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-6105
Mailing Address - Country:US
Mailing Address - Phone:606-772-1030
Mailing Address - Fax:606-451-0558
Practice Address - Street 1:4341 S HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-6105
Practice Address - Country:US
Practice Address - Phone:606-772-1030
Practice Address - Fax:606-451-0558
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-24
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2528361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical