Provider Demographics
NPI:1427733195
Name:FERM, KAITLYN ELIZABETH (LSW)
Entity type:Individual
Prefix:MRS
First Name:KAITLYN
Middle Name:ELIZABETH
Last Name:FERM
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:ELIZABETH
Other - Last Name:FERM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LSW
Mailing Address - Street 1:68 WABASH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-5435
Mailing Address - Country:US
Mailing Address - Phone:412-455-6890
Mailing Address - Fax:412-455-6891
Practice Address - Street 1:1407 MOUNT ROYAL BLVD
Practice Address - Street 2:
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-2205
Practice Address - Country:US
Practice Address - Phone:412-455-6890
Practice Address - Fax:412-455-6891
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140242104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker