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General NPI Number Information
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NPI Number | 1336634088
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Entity Type | Individual
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Provider Name | MRS. CASSANDRA KATENKAMP
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Gender | Female
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Dates
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Enumeration Date | 06/26/2018
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Last Update Date | 11/15/2023
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Provider Practice Location Address
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Address Line | 10999 REED HARTMAN HWY STE 107
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City | BLUE ASH
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State | OH
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Zip | 45242-8315
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Country | US
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Telephone | 812-212-9179
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Fax |
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Provider Business Mailing Address
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Address Line | 10999 REED HARTMAN HWY STE 207
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City | BLUE ASH
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State | OH
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Zip | 45242-8301
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Country | US
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Telephone | 812-212-9179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.2103655
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2303753
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License Number State | OH
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