Individual
CATHERINE PORTER PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
130 S JOE B HALL AVE, SHEPHERDSVILLE, KY 40165-6009
(502) 955-6445
(502) 955-9605
Mailing address
101 W MUHAMMAD ALI BLVD, LOUISVILLE, KY 40202-1423
(502) 589-8600
(502) 589-8745
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1279
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000210189
ANTHEM
KY
01
—
11490721
CAQH
—
05
—
30605018
—
KY
01
—
341187
TRICARE
KY
05
—
7100288020
—
KY
Enumeration date
05/25/2006
Last updated
05/23/2016
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