Basic Information
| Provider Information | |||||||||
| NPI: | 1932357837 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOGELMANN | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | LLMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1892 CONLEY RD | ||||||||
| Address2: | |||||||||
| City: | ATTICA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484129772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483433033 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1420 W. UNIVERSITY | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102380475 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2008 | ||||||||
| LastUpdateDate: | 08/31/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 6801090145 | MI | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.