Provider Demographics
NPI:1912112533
Name:SENN, KATHLEEN J (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:J
Last Name:SENN
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 1:4770 COVERT AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-5617
Mailing Address - Country:US
Mailing Address - Phone:812-475-3420
Mailing Address - Fax:812-475-3470
Practice Address - Street 1:4770 COVERT AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-5617
Practice Address - Country:US
Practice Address - Phone:812-475-3420
Practice Address - Fax:812-475-3470
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34004099A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical