Provider Demographics
NPI:1306018015
Name:ALTAVILLA, KAY FRANCES (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KAY
Middle Name:FRANCES
Last Name:ALTAVILLA
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 1:537 VENARD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-1249
Mailing Address - Country:US
Mailing Address - Phone:570-587-5747
Mailing Address - Fax:570-586-0030
Practice Address - Street 1:537 VENARD RD
Practice Address - Street 2:
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-1249
Practice Address - Country:US
Practice Address - Phone:570-587-5747
Practice Address - Fax:570-586-0030
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0149921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical