Provider Demographics
NPI:1326337429
Name:BUSH, KATHERINE SOPHIA (LCSW, MSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SOPHIA
Last Name:BUSH
Suffix:
Gender:F
Credentials:LCSW, MSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:SOPHIA
Other - Last Name:DEWEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:2326 ROMINE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2616
Mailing Address - Country:US
Mailing Address - Phone:717-870-7342
Mailing Address - Fax:
Practice Address - Street 1:8235 OHIO RIVER BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-1454
Practice Address - Country:US
Practice Address - Phone:412-766-4030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0192051041C0700X
IN34006123A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical