Provider Demographics
NPI:1891317814
Name:KATHRYN HOCKENBERRY LCSW LLC
Entity Type:Organization
Organization Name:KATHRYN HOCKENBERRY LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOCKENBERRY
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:814-650-9745
Mailing Address - Street 1:467 CHURCH LN
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-5241
Mailing Address - Country:US
Mailing Address - Phone:814-650-9745
Mailing Address - Fax:
Practice Address - Street 1:467 CHURCH LN
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-5241
Practice Address - Country:US
Practice Address - Phone:814-650-9745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty