Provider Demographics
NPI:1962209197
Name:KINDLER, KATHRYN BROOKE (LMSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BROOKE
Last Name:KINDLER
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:WV
Mailing Address - Zip Code:25425-7293
Mailing Address - Country:US
Mailing Address - Phone:434-242-7110
Mailing Address - Fax:
Practice Address - Street 1:8504 MAPLEVILLE RD
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1817
Practice Address - Country:US
Practice Address - Phone:301-733-9067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD32772104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker