Provider Demographics
NPI:1639647779
Name:BESCHE, KATIE (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:
Last Name:BESCHE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2808 RUSTIC MANOR CT
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21738-9747
Mailing Address - Country:US
Mailing Address - Phone:804-814-3346
Mailing Address - Fax:
Practice Address - Street 1:12800 FREDERICK RD STE 201
Practice Address - Street 2:
Practice Address - City:WEST FRIENDSHIP
Practice Address - State:MD
Practice Address - Zip Code:21794-9564
Practice Address - Country:US
Practice Address - Phone:804-814-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-07
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD148651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical