Provider Demographics
NPI:1952105124
Name:ALLEN, KATHERINE JANE (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JANE
Last Name:ALLEN
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 MACARTHUR ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32205-8911
Mailing Address - Country:US
Mailing Address - Phone:470-219-0781
Mailing Address - Fax:
Practice Address - Street 1:1267 MACARTHUR ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-8911
Practice Address - Country:US
Practice Address - Phone:470-219-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14214591-35011041C0700X
FLSW178481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical