=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811068927
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHY KOTTLER LCSW, ACSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/11/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 311 S CRAIG ST STE 2D
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15213-3731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-681-5659
-----------------------------------------------------
Fax | 412-681-2280
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 311 S CRAIG ST STE 2D
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15213-3731
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-681-5659
-----------------------------------------------------
Fax | 412-681-2280
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | CW006859L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------