Provider Demographics
NPI:1407505365
Name:LACENERE, KATHERINE IRENE (LSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:IRENE
Last Name:LACENERE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 CELEBRATION WAY APT 3304
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-1240
Mailing Address - Country:US
Mailing Address - Phone:609-571-2284
Mailing Address - Fax:
Practice Address - Street 1:702 CELEBRATION WAY APT 3304
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-1240
Practice Address - Country:US
Practice Address - Phone:609-571-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-19
Last Update Date:2024-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1089811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical