Provider Demographics
NPI:1578218749
Name:POLINO, KATE ERIN NELSON (LCSW)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:ERIN NELSON
Last Name:POLINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:ERIN
Other - Last Name:NELSON POLINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:822 CRANE BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGARLOAF KEY
Mailing Address - State:FL
Mailing Address - Zip Code:33042-3164
Mailing Address - Country:US
Mailing Address - Phone:618-926-5283
Mailing Address - Fax:
Practice Address - Street 1:822 CRANE BLVD
Practice Address - Street 2:
Practice Address - City:SUGARLOAF KEY
Practice Address - State:FL
Practice Address - Zip Code:33042-3164
Practice Address - Country:US
Practice Address - Phone:618-926-5283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW195311041C0700X
IL149.0169901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical