Provider Demographics
NPI:1457673758
Name:SMALL, KATHERINE SEXTON (MSS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SEXTON
Last Name:SMALL
Suffix:
Gender:F
Credentials:MSS
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:SMALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSS
Mailing Address - Street 1:301 OXFORD VALLEY RD
Mailing Address - Street 2:SUITE 603A
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7706
Mailing Address - Country:US
Mailing Address - Phone:215-428-1037
Mailing Address - Fax:
Practice Address - Street 1:301 OXFORD VALLEY RD
Practice Address - Street 2:SUITE 603A
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7706
Practice Address - Country:US
Practice Address - Phone:215-428-1037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-28
Last Update Date:2010-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0129271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical