Provider Demographics
NPI:1760514400
Name:KURTZ, KATHLEEN JAMES (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:JAMES
Last Name:KURTZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5979 NW 151 ST
Mailing Address - Street 2:201
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014
Mailing Address - Country:US
Mailing Address - Phone:305-823-7314
Mailing Address - Fax:305-823-3014
Practice Address - Street 1:5979 NW 151 ST
Practice Address - Street 2:201
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014
Practice Address - Country:US
Practice Address - Phone:305-823-7314
Practice Address - Fax:305-823-3014
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW471104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker