Provider Demographics
NPI:1679805634
Name:STEWART, KATHERINE RHODES (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:RHODES
Last Name:STEWART
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:RHODES
Other - Last Name:JOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:413 N. MONTGOMERY STREET
Mailing Address - Street 2:
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648
Mailing Address - Country:US
Mailing Address - Phone:814-695-2200
Mailing Address - Fax:814-695-2204
Practice Address - Street 1:413 N. MONTGOMERY STREET
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648
Practice Address - Country:US
Practice Address - Phone:814-695-2200
Practice Address - Fax:814-695-2204
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102635575Medicaid