Basic Information
| Provider Information | |||||||||
| NPI: | 1598917924 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUNG | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | BARNETT | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW, CSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 172 STAPLETON WAY | ||||||||
| Address2: | |||||||||
| City: | GEORGETOWN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 403242674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8597975354 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 343 WALLER AVE STE 201 | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405042918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592719448 | ||||||||
| FaxNumber: | 8592726893 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2008 | ||||||||
| LastUpdateDate: | 06/21/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6193 | KY | N | Behavioral Health & Social Service Providers | Social Worker | 171M00000X | 6193 | KY | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.