Provider Demographics
NPI:1134456189
Name:KAVALSKY, KATHERINE CASTLE (LGSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CASTLE
Last Name:KAVALSKY
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 LA SALLE RD
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-2001
Mailing Address - Country:US
Mailing Address - Phone:410-321-6035
Mailing Address - Fax:
Practice Address - Street 1:8600 LASALLE RD
Practice Address - Street 2:THE CHESTER BUILDING, SUITE 325
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2001
Practice Address - Country:US
Practice Address - Phone:410-321-6035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13983104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker