Provider Demographics
NPI:1295860757
Name:DEAN, KATHRYN ANNE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ANNE
Last Name:DEAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3311
Mailing Address - Country:US
Mailing Address - Phone:989-667-9661
Mailing Address - Fax:989-667-9680
Practice Address - Street 1:3253 CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-3106
Practice Address - Country:US
Practice Address - Phone:989-793-4790
Practice Address - Fax:989-793-1641
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010612451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical