Provider Demographics
NPI:1679877864
Name:DEFORD, KATHLEEN F (LCSW / MSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:F
Last Name:DEFORD
Suffix:
Gender:F
Credentials:LCSW / MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 S CHAPEL ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-3467
Mailing Address - Country:US
Mailing Address - Phone:302-224-1400
Mailing Address - Fax:302-224-1402
Practice Address - Street 1:910 S CHAPEL ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-3467
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:302-224-1402
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical