MEDICARE: MRS. KATHERINE MARIE SCHWENK LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	079958-1	NY
2	1041C0700X	Clinical Social Worker	6075	SD

General Provider Information

NPI Number	:	1184878993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHERINE MARIE SCHWENK LCSW

Provider Business Mailing Address
First Line	:	4723 COAL BANK DR
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-6515
Country	:	US
Telephone Number	:	585-478-7811
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 N 5TH ST STE 113
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57701-1375
Country	:	US
Telephone Number	:	585-478-7811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	10/21/2024

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