Provider Demographics
NPI:1740311331
Name:O'LOUGHLIN, KATHRYN M (LMSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:M
Last Name:O'LOUGHLIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 OLD SHOP RD
Mailing Address - Street 2:
Mailing Address - City:CROSS RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10518-1402
Mailing Address - Country:US
Mailing Address - Phone:914-672-5608
Mailing Address - Fax:
Practice Address - Street 1:332 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3005
Practice Address - Country:US
Practice Address - Phone:914-666-0191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069211104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker