Provider Demographics
NPI:1053933341
Name:DUPRE, KATHERINE (LISW-CP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:DUPRE
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 PARK PL S
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-5263
Mailing Address - Country:US
Mailing Address - Phone:843-475-4727
Mailing Address - Fax:
Practice Address - Street 1:1215 PARK PL S
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-5263
Practice Address - Country:US
Practice Address - Phone:843-475-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC114531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical