Individual
KATHERINE SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
401 HIGHLAND PARK DR, RICHMOND, KY 40475-3839
(859) 626-7700
(859) 626-7890
Mailing address
1010 MAIN ST SOUTH, MC KEE, KY 40447-7089
(859) 626-7700
(859) 626-7890
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3067
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100095610
—
KY
Enumeration date
04/24/2009
Last updated
02/07/2014
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