Provider Demographics
NPI:1407505365
Name:LACENERE, KATHERINE IRENE (LSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:IRENE
Last Name:LACENERE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 NUTT RD APT A201
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-3305
Mailing Address - Country:US
Mailing Address - Phone:609-571-2284
Mailing Address - Fax:
Practice Address - Street 1:495 NUTT RD APT A201
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3305
Practice Address - Country:US
Practice Address - Phone:609-571-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-19
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW136364104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker