Provider Demographics
NPI:1386046738
Name:PRICE, KATIE MICHELLE (LICSW)
Entity type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:MICHELLE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:MICHELLE
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:1011 S L ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4036
Mailing Address - Country:US
Mailing Address - Phone:253-237-2885
Mailing Address - Fax:
Practice Address - Street 1:1011 S L ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4036
Practice Address - Country:US
Practice Address - Phone:253-237-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-17
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60767308104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker