Provider Demographics
NPI:1124324819
Name:KATARA, VIVEK K (LCSW)
Entity type:Individual
Prefix:
First Name:VIVEK
Middle Name:K
Last Name:KATARA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:881 3RD ST STE B5
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5929
Mailing Address - Country:US
Mailing Address - Phone:610-776-9440
Mailing Address - Fax:610-776-9444
Practice Address - Street 1:881 3RD ST STE B5
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5929
Practice Address - Country:US
Practice Address - Phone:610-776-9440
Practice Address - Fax:610-776-9444
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0210231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical