Provider Demographics
NPI:1245208032
Name:POWERS, KATHERINE R (PHD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:R
Last Name:POWERS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 YORKTOWN PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-4926
Mailing Address - Country:US
Mailing Address - Phone:412-242-0381
Mailing Address - Fax:
Practice Address - Street 1:21 YOST BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-5283
Practice Address - Country:US
Practice Address - Phone:412-829-7223
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-4538-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
430301Medicare ID - Type Unspecified