Healthcare Provider Details

I. General information

NPI: 1841062635
Provider Name (Legal Business Name): KATHLEEN HORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 POINTE CIR STE 3201
GREENVILLE SC
29615-6307
US

IV. Provider business mailing address

PO BOX 748465
ATLANTA GA
30374-8465
US

V. Phone/Fax

Practice location:
  • Phone: 855-284-7483
  • Fax: 617-807-0958
Mailing address:
  • Phone: 855-284-7483
  • Fax: 617-807-0958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17618
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number14830
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: