Provider Demographics
NPI:1922585884
Name:HORRUM, KATHERINE MARIA (LICSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MARIA
Last Name:HORRUM
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:ZACH
Other - Middle Name:
Other - Last Name:HORRUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2126 N 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-3670
Mailing Address - Country:US
Mailing Address - Phone:402-934-1617
Mailing Address - Fax:402-934-5228
Practice Address - Street 1:2126 N 117TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3670
Practice Address - Country:US
Practice Address - Phone:402-934-1617
Practice Address - Fax:402-934-5228
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7244104100000X
NE3179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health