Provider Demographics
NPI:1982750857
Name:PITCHFORD, KATHRYN M (LISW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:M
Last Name:PITCHFORD
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:PITCHFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:5348 LAMME RD
Mailing Address - Street 2:
Mailing Address - City:MORAINE
Mailing Address - State:OH
Mailing Address - Zip Code:45439-3215
Mailing Address - Country:US
Mailing Address - Phone:937-534-4651
Mailing Address - Fax:937-534-4649
Practice Address - Street 1:5350 LAMME RD
Practice Address - Street 2:
Practice Address - City:MORAINE
Practice Address - State:OH
Practice Address - Zip Code:45439-3215
Practice Address - Country:US
Practice Address - Phone:937-534-4651
Practice Address - Fax:937-534-4669
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI84811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH446430Medicare PIN