Healthcare Provider Details

I. General information

NPI: 1821608258
Provider Name (Legal Business Name): KATHARINE MARIE HARGREAVES LCSW, LCAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 01/19/2023
Certification Date: 01/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 E FRANKLIN ST # 1121
CHAPEL HILL NC
27514-5851
US

IV. Provider business mailing address

1710 E FRANKLIN ST # 1121
CHAPEL HILL NC
27514-5851
US

V. Phone/Fax

Practice location:
  • Phone: 919-213-0292
  • Fax:
Mailing address:
  • Phone: 919-213-0292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLCAS-26516
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC015197
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: