Individual
KATHERINE LINCICUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6957 CALIFORNIA AVE SW, SEATTLE, WA 98136-1953
(206) 938-5947
Mailing address
11303 W WASHINGTON BLVD, LOS ANGELES, CA 90066-6003
(310) 482-3260
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95-389-3470
—
CA
05
—
953893470
—
CA
Enumeration date
09/19/2011
Last updated
10/27/2022
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