Healthcare Provider Details

I. General information

NPI: 1427460989
Provider Name (Legal Business Name): MS. KATHERINE FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2014
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

732 W BAYSHORE DR
TARPON SPRINGS FL
34689-2445
US

IV. Provider business mailing address

732 W BAYSHORE DR
TARPON SPRINGS FL
34689-2445
US

V. Phone/Fax

Practice location:
  • Phone: 614-880-8686
  • Fax:
Mailing address:
  • Phone: 401-523-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberNA
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: