Provider Demographics
NPI:1417246125
Name:DELORENZO, KATHERINE VIRGINIA (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:VIRGINIA
Last Name:DELORENZO
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 1:2144 OAK TER
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-4422
Mailing Address - Country:US
Mailing Address - Phone:617-223-1025
Mailing Address - Fax:
Practice Address - Street 1:5380 GULF OF MEXICO DR
Practice Address - Street 2:
Practice Address - City:LONGBOAT KEY
Practice Address - State:FL
Practice Address - Zip Code:34228-2048
Practice Address - Country:US
Practice Address - Phone:617-223-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY73-0780551041C0700X
FLSW142951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical