Provider Demographics
NPI:1679574958
Name:SPRINGER, KATHY F (LISW,LICDC)
Entity type:Individual
Prefix:MS
First Name:KATHY
Middle Name:F
Last Name:SPRINGER
Suffix:
Gender:F
Credentials:LISW,LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6927 FATHER CARUSO DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-2012
Mailing Address - Country:US
Mailing Address - Phone:216-651-3721
Mailing Address - Fax:
Practice Address - Street 1:17535 ROSBOUGH BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-8361
Practice Address - Country:US
Practice Address - Phone:440-234-2888
Practice Address - Fax:440-234-2035
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00049031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW18591Medicare ID - Type Unspecified