Provider Demographics
NPI:1336305333
Name:SEAGROVES, KATHY L (LCSW-C, LCSW)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:L
Last Name:SEAGROVES
Suffix:
Gender:F
Credentials:LCSW-C, LCSW
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:SEAGROVES
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-C, LCSW
Mailing Address - Street 1:PO BOX 5313
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20775-1313
Mailing Address - Country:US
Mailing Address - Phone:301-218-7727
Mailing Address - Fax:
Practice Address - Street 1:3102 FLORAL PARK RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-9665
Practice Address - Country:US
Practice Address - Phone:301-292-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128931041C0700X
VA09040060311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical