Basic Information
| Provider Information | |||||||||
| NPI: | 1780842716 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STORMER | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1380 RTE 286 HWY E | ||||||||
| Address2: | 524 | ||||||||
| City: | INDIANA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157011461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244650369 | ||||||||
| FaxNumber: | 7244651081 | ||||||||
| Practice Location | |||||||||
| Address1: | 1380 RTE 286 HWY E | ||||||||
| Address2: | 524 | ||||||||
| City: | INDIANA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 157011461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244650369 | ||||||||
| FaxNumber: | 7244651081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2008 | ||||||||
| LastUpdateDate: | 11/14/2012 | ||||||||
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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 | 101YP2500X | PC006516 | PA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.