Provider Demographics
NPI:1811925118
Name:REEDY, CATHERINE M (MSW)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:M
Last Name:REEDY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 CHANCELLOR DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3487
Mailing Address - Country:US
Mailing Address - Phone:859-344-0322
Mailing Address - Fax:859-344-6291
Practice Address - Street 1:2734 CHANCELLOR DR
Practice Address - Street 2:SUITE 104
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-3487
Practice Address - Country:US
Practice Address - Phone:859-344-0322
Practice Address - Fax:859-344-6291
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY05481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCSW0090Medicare ID - Type Unspecified