Provider Demographics
NPI:1578634192
Name:MOLDOVAN, KATHERINE ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:MOLDOVAN
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 1:2820 W CHARLESTON BLVD
Mailing Address - Street 2:#C23
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-1942
Mailing Address - Country:US
Mailing Address - Phone:702-437-4673
Mailing Address - Fax:702-438-4673
Practice Address - Street 1:2820 W CHARLESTON BLVD
Practice Address - Street 2:#C23
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1942
Practice Address - Country:US
Practice Address - Phone:702-437-4673
Practice Address - Fax:702-438-4673
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4474-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical