Provider Demographics
NPI:1669770749
Name:KURTZ, KATHERINE (MSW, LISW-S)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:
Last Name:KURTZ
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:KURTZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3114 W 159TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-1036
Mailing Address - Country:US
Mailing Address - Phone:216-789-9726
Mailing Address - Fax:
Practice Address - Street 1:3114 W 159TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-1036
Practice Address - Country:US
Practice Address - Phone:216-789-9726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-14
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.11001051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical