Provider Demographics
NPI:1508108937
Name:HOGAN, CATHERINE LOUNSBERY (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LOUNSBERY
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25235 SE KLAHANIE BLVD
Mailing Address - Street 2:UNIT E104
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-5778
Mailing Address - Country:US
Mailing Address - Phone:425-223-9415
Mailing Address - Fax:
Practice Address - Street 1:310 3RD AVE NE
Practice Address - Street 2:SUITE 110
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-3300
Practice Address - Country:US
Practice Address - Phone:425-223-9415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-24
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW601092131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical