Healthcare Provider Details

I. General information

NPI: 1073363271
Provider Name (Legal Business Name): KATHRYN CUDD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 3RD AVE FL 10
NEW YORK NY
10017-6708
US

IV. Provider business mailing address

11179 SW 54TH CIR
OCALA FL
34476-9707
US

V. Phone/Fax

Practice location:
  • Phone: 212-284-7206
  • Fax:
Mailing address:
  • Phone: 352-275-9671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW22712
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: