Provider Demographics
NPI:1518510098
Name:GRANT, KATHERINE (LICSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GRANT
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 1:7411 W CLEARWATER AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1683
Mailing Address - Country:US
Mailing Address - Phone:208-549-9945
Mailing Address - Fax:
Practice Address - Street 1:7411 W CLEARWATER AVE UNIT B
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1683
Practice Address - Country:US
Practice Address - Phone:208-549-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW613395641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical