Provider Demographics
NPI:1306558747
Name:KATHERINE R SPRAGG LLC
Entity type:Organization
Organization Name:KATHERINE R SPRAGG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SPRAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-954-8013
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:NEW BREMEN
Mailing Address - State:OH
Mailing Address - Zip Code:45869-0265
Mailing Address - Country:US
Mailing Address - Phone:419-954-8013
Mailing Address - Fax:
Practice Address - Street 1:404 HAMILTON RD STE 4
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-1156
Practice Address - Country:US
Practice Address - Phone:419-405-3508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty