Provider Demographics
NPI:1649793969
Name:BROCKETT, KATHRYN B (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:B
Last Name:BROCKETT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:B
Other - Last Name:BROCKETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:49 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-2906
Mailing Address - Country:US
Mailing Address - Phone:828-713-7541
Mailing Address - Fax:
Practice Address - Street 1:356 BILTMORE AVE STE 200
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4504
Practice Address - Country:US
Practice Address - Phone:828-254-2700
Practice Address - Fax:828-254-1524
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0087671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical