Provider Demographics
NPI:1770714966
Name:ARCH, KATHLEEN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:ARCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 MEADOWOOD BLVD
Mailing Address - Street 2:APT. 208
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4703
Mailing Address - Country:US
Mailing Address - Phone:414-426-3226
Mailing Address - Fax:
Practice Address - Street 1:3130 S RAINBOW BLVD STE 304
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6212
Practice Address - Country:US
Practice Address - Phone:702-202-3374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical