Provider Demographics
NPI:1336273689
Name:DIMITRE, KATHERINE HB (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:HB
Last Name:DIMITRE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1332
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-0045
Mailing Address - Country:US
Mailing Address - Phone:541-772-3349
Mailing Address - Fax:541-772-3349
Practice Address - Street 1:901 BEACH ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3238
Practice Address - Country:US
Practice Address - Phone:541-772-3349
Practice Address - Fax:541-772-3349
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical