Provider Demographics
NPI:1871868448
Name:EVANS, KATHARINE A (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:A
Last Name:EVANS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KATHARINE
Other - Middle Name:A
Other - Last Name:GUTTING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:710 W 168TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3726
Mailing Address - Country:US
Mailing Address - Phone:212-342-0571
Mailing Address - Fax:212-342-1246
Practice Address - Street 1:710 W 168TH ST
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3726
Practice Address - Country:US
Practice Address - Phone:212-342-0571
Practice Address - Fax:212-342-1246
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-15
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0844751041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical