Basic Information
| Provider Information | |||||||||
| NPI: | 1427580133 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KATIE PHILLIPS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1943 W 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432121902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143055102 | ||||||||
| FaxNumber: | 6143837786 | ||||||||
| Practice Location | |||||||||
| Address1: | 1943 W 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432121902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6143055102 | ||||||||
| FaxNumber: | 6143837786 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2017 | ||||||||
| LastUpdateDate: | 03/31/2017 | ||||||||
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| AuthorizedOfficialLastName: | PHILLIPS | ||||||||
| AuthorizedOfficialFirstName: | KATHRYN | ||||||||
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| AuthorizedOfficialTitleorPosition: | LICENSED INDEPENDENT SOCIAL WORKER | ||||||||
| AuthorizedOfficialTelephone: | 6142963166 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LISWS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | I.1302343-S | OH | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.