Provider Demographics
NPI:1912985441
Name:HOWARD, KATHY (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6816 SHADOWLAWN DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-7354
Mailing Address - Country:US
Mailing Address - Phone:859-635-1482
Mailing Address - Fax:859-635-1482
Practice Address - Street 1:1717 DIXIE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:FT WRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41011-2766
Practice Address - Country:US
Practice Address - Phone:859-578-4143
Practice Address - Fax:859-344-3183
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 00038821041C0700X
KY13301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64194087Medicaid
KY1051101Medicare ID - Type UnspecifiedMEDICARE