Provider Demographics
NPI:1306903521
Name:DOWLING, KATHLEEN ANNE (MA,CPAT, CADC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:ANNE
Last Name:DOWLING
Suffix:
Gender:F
Credentials:MA,CPAT, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:KY
Mailing Address - Zip Code:40031-1431
Mailing Address - Country:US
Mailing Address - Phone:502-741-2695
Mailing Address - Fax:502-225-9901
Practice Address - Street 1:313 W MADISON ST
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:KY
Practice Address - Zip Code:40031-1431
Practice Address - Country:US
Practice Address - Phone:502-741-2695
Practice Address - Fax:502-225-9901
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0169101YA0400X
KY0013101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health