Provider Demographics
NPI:1942433784
Name:DOWELL, KATRINA L (LCSW)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:L
Last Name:DOWELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:S
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1500 N WESTWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-3318
Mailing Address - Country:US
Mailing Address - Phone:573-472-2139
Mailing Address - Fax:573-472-6457
Practice Address - Street 1:1500 N WESTWOOD BLVD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-3318
Practice Address - Country:US
Practice Address - Phone:573-472-2139
Practice Address - Fax:573-472-6457
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical