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NPI Code Detail

MEDICARE: NATASCHA KATOVICH LCSW

MEDICARE:   NATASCHA  KATOVICH  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW10258

General Provider Information

NPI Number : 1699421560
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASCHA KATOVICH LCSW
Provider Business Mailing Address
First Line : PO BOX 1646
Second Line :
City : LAKE CITY
State : FL
Zip : 32056-1646
Country : US
Telephone Number : 773-531-6692
Fax Number :
Provider Business Practice Location Address
First Line : 4812 W US HIGHWAY 90
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-5126
Country : US
Telephone Number : 386-466-1106
Fax Number : 386-466-1802
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2022
Last Update Date : 03/01/2022

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Directions to “ NATASCHA KATOVICH LCSW” Practice Location

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