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General NPI Number Information
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NPI Number | 1477653905
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Entity Type | Individual
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Provider Name | KATHLEEN C. ATWELL LCSW, BCD
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Gender | Female
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 400 3RD AVE STE 211
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City | KINGSTON
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State | PA
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Zip | 18704-5816
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Country | US
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Telephone | 570-283-1600
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Fax | 570-283-5515
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Provider Business Mailing Address
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Address Line | 400 3RD AVE STE 211
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City | KINGSTON
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State | PA
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Zip | 18704-5816
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Country | US
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Telephone | 570-283-1600
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Fax | 570-283-5515
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW002234L
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License Number State | PA
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