Provider Demographics
NPI:1477895118
Name:PEINOVICH, KATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:PEINOVICH
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 1:317 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-2713
Mailing Address - Country:US
Mailing Address - Phone:917-952-5702
Mailing Address - Fax:
Practice Address - Street 1:36 PLAZA ST E
Practice Address - Street 2:SUITE 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5048
Practice Address - Country:US
Practice Address - Phone:917-952-5702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0739851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical