Provider Demographics
NPI:1912290867
Name:SJOSTROM, KATE N (LCSW)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:N
Last Name:SJOSTROM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1353 SWEETWATER DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7872
Mailing Address - Country:US
Mailing Address - Phone:615-667-0037
Mailing Address - Fax:615-331-5649
Practice Address - Street 1:617 POTOMAC PL STE 403
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5657
Practice Address - Country:US
Practice Address - Phone:615-667-0037
Practice Address - Fax:615-331-5649
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2023-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN55731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5573OtherSTATE OF TENNESSEE