Provider Demographics
NPI:1326372467
Name:OSWALD, KATHERINE L (MSW, CSW-PIP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:OSWALD
Suffix:
Gender:F
Credentials:MSW, CSW-PIP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BENDEWALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, CSW-PIP
Mailing Address - Street 1:12167 POINTS LN
Mailing Address - Street 2:
Mailing Address - City:DEADWOOD
Mailing Address - State:SD
Mailing Address - Zip Code:57732-7374
Mailing Address - Country:US
Mailing Address - Phone:605-310-0356
Mailing Address - Fax:605-716-4397
Practice Address - Street 1:12167 POINTS LN
Practice Address - Street 2:
Practice Address - City:DEADWOOD
Practice Address - State:SD
Practice Address - Zip Code:57732-7374
Practice Address - Country:US
Practice Address - Phone:605-310-0356
Practice Address - Fax:605-716-4397
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-22
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
SD31021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1326372467OtherMEDICARE ID