Provider Demographics
NPI:1336474139
Name:EICHER, KATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:EICHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:HOSTETLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 LAKESHORE PT
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-3843
Mailing Address - Country:US
Mailing Address - Phone:912-510-3420
Mailing Address - Fax:912-510-3425
Practice Address - Street 1:205 LAKESHORE PT
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3843
Practice Address - Country:US
Practice Address - Phone:912-510-3420
Practice Address - Fax:912-510-3425
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW017143101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health