Provider Demographics
NPI:1346513488
Name:WEBB, KATHERINE LA SHAN (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:LA SHAN
Last Name:WEBB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 ELEPHANT TRL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3016
Mailing Address - Country:US
Mailing Address - Phone:770-535-1050
Mailing Address - Fax:770-534-8204
Practice Address - Street 1:1050 ELEPHANT TRL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3016
Practice Address - Country:US
Practice Address - Phone:770-535-1050
Practice Address - Fax:770-534-8204
Is Sole Proprietor?:No
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0037171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical