Provider Demographics
NPI:1306957576
Name:NOLAN-GOSLING, KATHLEEN MARIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:NOLAN-GOSLING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:KATHY
Other - Middle Name:MARIE
Other - Last Name:NOLAN-GOSLING CHRISTOPHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:849 DIAS DR CHICO CA 95926
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3175
Mailing Address - Country:US
Mailing Address - Phone:530-342-5590
Mailing Address - Fax:530-342-5590
Practice Address - Street 1:341 BROADWAY STREET STE 303
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-342-5590
Practice Address - Fax:530-342-5590
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS151501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ233082Medicare ID - Type Unspecified