Provider Demographics
NPI:1407525546
Name:HOOVER, KATHRYN M (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:HOOVER
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 1:18865 FL 54
Mailing Address - Street 2:SUITE 124
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558
Mailing Address - Country:US
Mailing Address - Phone:513-614-5678
Mailing Address - Fax:
Practice Address - Street 1:18865 FL 54
Practice Address - Street 2:SUITE 124
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-3355
Practice Address - Country:US
Practice Address - Phone:813-413-6823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-11
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL150991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical