Provider Demographics
NPI:1376928119
Name:DAVLANTIS, KATHERINE SARAH (PHD, LCSW, BCBA)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:SARAH
Last Name:DAVLANTIS
Suffix:
Gender:F
Credentials:PHD, LCSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GLENHIGH CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5200
Mailing Address - Country:US
Mailing Address - Phone:310-947-2884
Mailing Address - Fax:
Practice Address - Street 1:101 GLENHIGH CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5200
Practice Address - Country:US
Practice Address - Phone:310-947-2884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0092791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical