Provider Demographics
NPI:1932405370
Name:BIDDLE, KATHRYN A (LISW-SUPV)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:A
Last Name:BIDDLE
Suffix:
Gender:F
Credentials:LISW-SUPV
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:A
Other - Last Name:BIDDLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW-SUPV
Mailing Address - Street 1:526 SUPERIOR ROAD SUITE 1400
Mailing Address - Street 2:CLEVELAND RAPE CRISIS CENTER
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114
Mailing Address - Country:US
Mailing Address - Phone:216-619-6194
Mailing Address - Fax:216-619-6195
Practice Address - Street 1:526 SUPERIOR ROAD SUITE 1400
Practice Address - Street 2:CLEVELAND RAPE CRISIS CENTER
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114
Practice Address - Country:US
Practice Address - Phone:216-619-6194
Practice Address - Fax:216-378-3906
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0004149-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0268768Medicaid