Healthcare Provider Details

I. General information

NPI: 1942622188
Provider Name (Legal Business Name): KATHERINE HOLBROOK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 ENOCH BLVD
SAVANNAH TN
38372-2240
US

IV. Provider business mailing address

175 ENOCH BLVD
SAVANNAH TN
38372-2240
US

V. Phone/Fax

Practice location:
  • Phone: 731-925-3200
  • Fax:
Mailing address:
  • Phone: 731-925-2300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9787
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL15209
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-35709
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: