Provider Demographics
NPI:1427512227
Name:WAMPOLD, KATHRYN DAVIS (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DAVIS
Last Name:WAMPOLD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:ANN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE # 8422
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-2300
Mailing Address - Fax:504-988-3969
Practice Address - Street 1:131 S ROBERTSON ST FL 14
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2807
Practice Address - Country:US
Practice Address - Phone:504-988-3533
Practice Address - Fax:504-988-0496
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical