Provider Demographics
NPI:1699477224
Name:KOESTER, KATHERINE (LMSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:KOESTER
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 1:8 SAYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-3104
Mailing Address - Country:US
Mailing Address - Phone:631-609-0133
Mailing Address - Fax:
Practice Address - Street 1:8 SAYWOOD LN
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-3104
Practice Address - Country:US
Practice Address - Phone:631-609-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112946104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker