Healthcare Provider Details

I. General information

NPI: 1811068927
Provider Name (Legal Business Name): KATHY KOTTLER LCSW, ACSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S CRAIG ST STE 2D
PITTSBURGH PA
15213-3731
US

IV. Provider business mailing address

311 S CRAIG ST STE 2D
PITTSBURGH PA
15213-3731
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-5659
  • Fax: 412-681-2280
Mailing address:
  • Phone: 412-681-5659
  • Fax: 412-681-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW006859L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: