Provider Demographics
NPI:1821641713
Name:GRABOW, CATHERINE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:GRABOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10520 BARKLEY ST STE 140
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-1823
Mailing Address - Country:US
Mailing Address - Phone:816-679-6149
Mailing Address - Fax:855-573-0890
Practice Address - Street 1:10520 BARKLEY ST STE 140
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-1823
Practice Address - Country:US
Practice Address - Phone:816-679-6149
Practice Address - Fax:855-573-0890
Is Sole Proprietor?:No
Enumeration Date:2019-07-19
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11048104100000X
KS056261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1821641713Medicaid