Provider Demographics
NPI:1215630207
Name:ENGLERT, KATELYN (LMSW)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:ENGLERT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BROCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14420-1934
Mailing Address - Country:US
Mailing Address - Phone:585-794-3750
Mailing Address - Fax:
Practice Address - Street 1:58 MARKET ST
Practice Address - Street 2:
Practice Address - City:BROCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14420-1934
Practice Address - Country:US
Practice Address - Phone:585-794-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099790104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker