Provider Demographics
NPI:1194922484
Name:SURMEIER, KATHERINE REID (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:REID
Last Name:SURMEIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:KATHERINE
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:3709 N GREENVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3609
Mailing Address - Country:US
Mailing Address - Phone:773-477-1782
Mailing Address - Fax:
Practice Address - Street 1:1300 W BELMONT AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3200
Practice Address - Country:US
Practice Address - Phone:773-913-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL49008141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical