Basic Information
| Provider Information | |||||||||
| NPI: | 1639426331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOHERTY | ||||||||
| FirstName: | KANDEE | ||||||||
| MiddleName: | WHITMAN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1633 PHILIPSBURG BIGLER HWY | ||||||||
| Address2: | CEN-CLEAR BEHAVIORAL HEALTH DIVISION | ||||||||
| City: | PHILIPSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 168668112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143425678 | ||||||||
| FaxNumber: | 8143420532 | ||||||||
| Practice Location | |||||||||
| Address1: | 580 OLD ROUTE 322 | ||||||||
| Address2: | BEHAVIORAL HEALTH DIVISION-CEN CLEAR | ||||||||
| City: | PHILIPSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16866 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8143425678 | ||||||||
| FaxNumber: | 8143420532 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2012 | ||||||||
| LastUpdateDate: | 10/19/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | CW017306 | PA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.