Provider Demographics
NPI:1568470862
Name:GEORGEOFF MOHR, KATHERINE A (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:A
Last Name:GEORGEOFF MOHR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MRS
Other - First Name:KATHERINE
Other - Middle Name:A
Other - Last Name:GEORGEOFF-WHITE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1137 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-2211
Mailing Address - Country:US
Mailing Address - Phone:765-404-0561
Mailing Address - Fax:
Practice Address - Street 1:3851 N RIVER RD
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-3762
Practice Address - Country:US
Practice Address - Phone:217-597-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34005466A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical