Provider Demographics
NPI:1619668944
Name:PRICE, KATHARINE MARIE (CDCA)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:MARIE
Last Name:PRICE
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1496 SOUTH GREEN ROAD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-4088
Mailing Address - Country:US
Mailing Address - Phone:216-389-7413
Mailing Address - Fax:216-916-0995
Practice Address - Street 1:1496 SOUTH GREEN ROAD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4088
Practice Address - Country:US
Practice Address - Phone:216-389-7413
Practice Address - Fax:216-916-0995
Is Sole Proprietor?:No
Enumeration Date:2023-05-17
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA184240101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)