Provider Demographics
NPI:1376981324
Name:GARANZINI, KATHERINE LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:LYNN
Last Name:GARANZINI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:2151 SKIBO RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-0252
Mailing Address - Country:US
Mailing Address - Phone:910-689-5333
Mailing Address - Fax:910-703-8632
Practice Address - Street 1:2151 SKIBO RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-0252
Practice Address - Country:US
Practice Address - Phone:910-689-5333
Practice Address - Fax:910-703-8632
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0190341041C0700X
NCP0086161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical