Provider Demographics
NPI:1194548834
Name:WARNER, KATHRYN (LCSWA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:558 WILSON LANE EXT
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7799
Mailing Address - Country:US
Mailing Address - Phone:828-719-6783
Mailing Address - Fax:
Practice Address - Street 1:558 WILSON LANE EXT
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7799
Practice Address - Country:US
Practice Address - Phone:828-719-6783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-01
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0212971041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical