Provider Demographics
NPI:1699035766
Name:WAUGH, KATHERINE (LISW-S)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WAUGH
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1910
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-7910
Mailing Address - Country:US
Mailing Address - Phone:330-687-9085
Mailing Address - Fax:614-887-7975
Practice Address - Street 1:470 OLDE WORTHINGTON RD
Practice Address - Street 2:STE 200
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8985
Practice Address - Country:US
Practice Address - Phone:330-687-9085
Practice Address - Fax:614-877-7975
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.11001931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical