Healthcare Provider Details

I. General information

NPI: 1962871681
Provider Name (Legal Business Name): KATONYA MCGIRT PHD, LICSW, CCHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5608 17TH AVE NW # 1115
SEATTLE WA
98107-5232
US

IV. Provider business mailing address

5608 17TH AVE NW STE 1115
SEATTLE WA
98107-5232
US

V. Phone/Fax

Practice location:
  • Phone: 253-244-3446
  • Fax: 253-793-0344
Mailing address:
  • Phone: 253-244-3446
  • Fax: 253-793-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberTPSW274
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number30808
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number60992901
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: