Provider Demographics
NPI:1932829033
Name:WEBSTER, KATHERINE ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:ANN
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1405 W PINE ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4983
Mailing Address - Country:US
Mailing Address - Phone:989-751-4054
Mailing Address - Fax:
Practice Address - Street 1:1405 W PINE ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4983
Practice Address - Country:US
Practice Address - Phone:989-751-4054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010904261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty