Healthcare Provider Details

I. General information

NPI: 1225755341
Provider Name (Legal Business Name): KATHERINE LANORE OREILLY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2022
Last Update Date: 09/08/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 E MAIN STREET
LOCUST NC
28097
US

IV. Provider business mailing address

4310 THERMAL AVE
MIDLAND NC
28107-9393
US

V. Phone/Fax

Practice location:
  • Phone: 704-438-5494
  • Fax:
Mailing address:
  • Phone: 704-888-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC017588
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: