Provider Demographics
NPI:1851493662
Name:MACKIEWICZ, CATHY MARIE (MSW, LCSW, LISW)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:MARIE
Last Name:MACKIEWICZ
Suffix:
Gender:F
Credentials:MSW, LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7430 US HIGHWAY 42
Mailing Address - Street 2:SUITE 211
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1989
Mailing Address - Country:US
Mailing Address - Phone:859-512-8083
Mailing Address - Fax:
Practice Address - Street 1:7430 US HIGHWAY 42
Practice Address - Street 2:SUITE 211
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1989
Practice Address - Country:US
Practice Address - Phone:859-512-8083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY 9481041C0700X
OHI-4740104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker