Provider Demographics
NPI:1457997090
Name:MINK, KATRINA (MSW)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:MINK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 WEILER ST
Mailing Address - Street 2:
Mailing Address - City:BRADDOCK
Mailing Address - State:PA
Mailing Address - Zip Code:15104-3062
Mailing Address - Country:US
Mailing Address - Phone:330-651-0544
Mailing Address - Fax:
Practice Address - Street 1:50 MONTGOMERY PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5237
Practice Address - Country:US
Practice Address - Phone:412-529-4160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical