Provider Demographics
NPI:1992951172
Name:WHITACRE, KATHRYN D (LCSW-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:D
Last Name:WHITACRE
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:D
Other - Last Name:CARDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:12501 WILLOWBROOK RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2569
Mailing Address - Country:US
Mailing Address - Phone:301-723-1443
Mailing Address - Fax:301-723-1480
Practice Address - Street 1:81 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3008
Practice Address - Country:US
Practice Address - Phone:301-268-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD129451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical