Kathleen C. Derise in Newport News - Clinical
Kathleen C. Derise - NPI 1629089248
Kathleen C. Derise is a Clinical in Newport News, Virginia. Kathleen C. Derise practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kathleen C. Derise is 1629089248. The last update date is 2007-07-08.
Kathleen C. Derise's current location address is 205 Lakewood Park Dr, Newport News, Virginia. You can contact this provider via phone number 7578778765. The mailing address for Kathleen C. Derise is 205 Lakewood Park Dr, Newport News, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kathleen C. Derise |
|---|---|
| Address | 205 Lakewood Park Dr, Newport News, Virginia |
| Phone Number | 7578778765 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1629089248 |
|---|---|
| Provider Enumeration Date | 2006-08-10 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 205 Lakewood Park Dr |
|---|---|
| City | Newport News |
| State | Virginia (VA) |
| Post Code | 236026261 |
| Phone Number | 7578778765 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 904000534 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique provider identifier assigned to Kathleen C. Derise?
The Kathleen C. Derise has been issued the NPI (National Provider Identifier) 1629089248 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Kathleen C. Derise?
The Kathleen C. Derise is situated at 205 Lakewood Park Dr, in the city of Newport News, state of VA, with the zip code 236026261.
What is the area of specialization for Kathleen C. Derise, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kathleen C. Derise is Clinical, and the corresponding taxonomy code that categorizes this area of expertise is 1041C0700X.
On what date did the Kathleen C. Derise receive the assignment of its 1629089248 from the Centers for Medicare & Medicaid Services?
The Kathleen C. Derise was issued its 1629089248 by the Centers for Medicare & Medicaid Services on 2006-08-10.
As of what date were the details related to Kathleen C. Derise most recently updated or revised?
The information pertaining to Kathleen C. Derise, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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