Provider Demographics
NPI:1710760491
Name:WOODFALL, KATHRINE ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRINE
Middle Name:ANNE
Last Name:WOODFALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 FAYS CT
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-4484
Mailing Address - Country:US
Mailing Address - Phone:914-391-8056
Mailing Address - Fax:
Practice Address - Street 1:25 FAYS CT
Practice Address - Street 2:
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-4484
Practice Address - Country:US
Practice Address - Phone:914-391-8056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty