Provider Demographics
NPI:1326441692
Name:ZWICK, KATHERINE (LCPC, LPCC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:ZWICK
Suffix:
Gender:F
Credentials:LCPC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WALNUT AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-3929
Mailing Address - Country:US
Mailing Address - Phone:831-275-5481
Mailing Address - Fax:
Practice Address - Street 1:104 WALNUT AVE STE 200
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-3929
Practice Address - Country:US
Practice Address - Phone:831-275-5481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC3334101YP2500X
IL180.009215101YP2500X
CA3334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional