Provider Demographics
NPI:1609005610
Name:STRUB, KATHERINE (LMHC, MA, NCC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:STRUB
Suffix:
Gender:F
Credentials:LMHC, MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 WATER ST
Mailing Address - Street 2:SUITE #403
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-4738
Mailing Address - Country:US
Mailing Address - Phone:319-404-2574
Mailing Address - Fax:319-232-6846
Practice Address - Street 1:722 WATER ST
Practice Address - Street 2:SUITE #403
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-4738
Practice Address - Country:US
Practice Address - Phone:319-404-2574
Practice Address - Fax:319-232-6846
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001141101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health