Provider Demographics
NPI:1306229133
Name:KURTZ, KATHRYN S (LMSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:S
Last Name:KURTZ
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:PO BOX 577
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-0577
Mailing Address - Country:US
Mailing Address - Phone:231-878-3807
Mailing Address - Fax:906-483-1394
Practice Address - Street 1:202 W WASHINGTON ST UNIT 577
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-6023
Practice Address - Country:US
Practice Address - Phone:231-878-3807
Practice Address - Fax:906-225-5533
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-29
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68-010958111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical