Provider Demographics
NPI:1316177363
Name:EHRGOTT, KATHRYN ELIZABETH (MSW)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:EHRGOTT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 SOUTH LEBANON STREET
Mailing Address - Street 2:BOONE COUNTY SERVICES
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052
Mailing Address - Country:US
Mailing Address - Phone:765-482-7421
Mailing Address - Fax:765-482-7462
Practice Address - Street 1:1005 SOUTH LEBANON STREET
Practice Address - Street 2:BOONE COUNTY SERVICES
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052
Practice Address - Country:US
Practice Address - Phone:765-482-7421
Practice Address - Fax:765-482-7462
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor