Healthcare Provider Details

I. General information

NPI: 1285837898
Provider Name (Legal Business Name): KATHERINE CONE PODLISKA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE MARIE CONE LCSW

II. Dates (important events)

Enumeration Date: 06/10/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GEB 2996 PANZER KASERNE
BOEBLINGEN GERMANY
71032
DE

IV. Provider business mailing address

CMR 480, BOX 997
APO AE
09128
US

V. Phone/Fax

Practice location:
  • Phone: 07031152676
  • Fax: 07031152967
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number40936
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12296
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: