Provider Demographics
NPI:1447573464
Name:ENGLERT, KATHRYN WHITE (LPCC-S, NBCC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:WHITE
Last Name:ENGLERT
Suffix:
Gender:F
Credentials:LPCC-S, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-3242
Mailing Address - Country:US
Mailing Address - Phone:270-777-4490
Mailing Address - Fax:866-824-4022
Practice Address - Street 1:2204 KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3242
Practice Address - Country:US
Practice Address - Phone:270-777-4490
Practice Address - Fax:866-441-1083
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1395101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1395OtherBOARD OF LICENSED PROFESSIONAL CLINICAL COUNSELORS
KY104170OtherLPCC