Provider Demographics
NPI:1336496546
Name:HERWIG, KATIE (LSCSW)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:HERWIG
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:R
Other - Last Name:KILGORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 S SANTA FE AVE
Mailing Address - Street 2:STE C
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4171
Mailing Address - Country:US
Mailing Address - Phone:785-823-6322
Mailing Address - Fax:
Practice Address - Street 1:600 S SANTA FE AVE
Practice Address - Street 2:STE C
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4171
Practice Address - Country:US
Practice Address - Phone:785-823-6322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS8411104100000X
KSLSCSW 44431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker