Provider Demographics
NPI:1467231910
Name:CLEVELAND, KATAMIE (LICSW)
Entity Type:Individual
Prefix:
First Name:KATAMIE
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 SOUTHCREST TRL
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5122
Mailing Address - Country:US
Mailing Address - Phone:703-785-3324
Mailing Address - Fax:
Practice Address - Street 1:150 S PERRY ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104-4227
Practice Address - Country:US
Practice Address - Phone:248-528-2116
Practice Address - Fax:502-996-8282
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2492C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical