Provider Demographics
NPI:1760105159
Name:MCBURNEY, KATELYN MARIE (LSW)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MARIE
Last Name:MCBURNEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N CLEVELAND MASSILLON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2484
Mailing Address - Country:US
Mailing Address - Phone:330-310-9878
Mailing Address - Fax:
Practice Address - Street 1:300 N CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2484
Practice Address - Country:US
Practice Address - Phone:330-310-9878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS2207479104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker