Provider Demographics
NPI:1689019689
Name:DURST, KATHLEEN (MA LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:DURST
Suffix:
Gender:F
Credentials:MA LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 PENN AVE
Mailing Address - Street 2:#609
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3803
Mailing Address - Country:US
Mailing Address - Phone:917-576-7169
Mailing Address - Fax:
Practice Address - Street 1:810 RIVER AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5917
Practice Address - Country:US
Practice Address - Phone:917-576-7169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078557-11041C0700X
PACW0171831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical