Provider Demographics
NPI:1538484159
Name:STEVKO, KATHERINE A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:A
Last Name:STEVKO
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 1:1304 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SARANAC LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12983-1962
Mailing Address - Country:US
Mailing Address - Phone:732-887-6369
Mailing Address - Fax:
Practice Address - Street 1:1304 PINE ST
Practice Address - Street 2:
Practice Address - City:SARANAC LAKE
Practice Address - State:NY
Practice Address - Zip Code:12983-1962
Practice Address - Country:US
Practice Address - Phone:732-887-6369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0795241041C0700X
NJ44SL05418000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker