Provider Demographics
NPI:1548968431
Name:BEDDOW, KATHRYN LYNNE (LMSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LYNNE
Last Name:BEDDOW
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 SWEETBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3908
Mailing Address - Country:US
Mailing Address - Phone:704-214-0680
Mailing Address - Fax:
Practice Address - Street 1:580 CITY CENTER BLVD STE 5
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-1880
Practice Address - Country:US
Practice Address - Phone:804-207-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical