Provider Demographics
NPI:1336361302
Name:PINEYRO, KATHRYN (LCSW)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:
Last Name:PINEYRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:KING-PINEYRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 566051
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33256-6051
Mailing Address - Country:US
Mailing Address - Phone:786-973-2823
Mailing Address - Fax:
Practice Address - Street 1:9769 S DIXIE HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-5600
Practice Address - Country:US
Practice Address - Phone:786-973-2823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364361041C0700X
NY0597961041C0700X
FLSW 8780101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSW 8780OtherLCSW
TX173093901Medicaid