Healthcare Provider Details

I. General information

NPI: 1760076087
Provider Name (Legal Business Name): KATHY B OVERMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 MCFARLAN RD STE 112A
KENNETT SQUARE PA
19348-2454
US

IV. Provider business mailing address

415 MCFARLAN RD STE 112A
KENNETT SQUARE PA
19348-2454
US

V. Phone/Fax

Practice location:
  • Phone: 302-540-0460
  • Fax:
Mailing address:
  • Phone: 302-540-0460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW023968
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: