Provider Demographics
NPI:1528353109
Name:SPRUILL, KATHERINE TAYLOR (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:TAYLOR
Last Name:SPRUILL
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:TOBUREN
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LCSW, LCAS
Mailing Address - Street 1:4748 RUSHING DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-8968
Mailing Address - Country:US
Mailing Address - Phone:910-622-1905
Mailing Address - Fax:
Practice Address - Street 1:4748 RUSHING DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-8968
Practice Address - Country:US
Practice Address - Phone:910-622-1905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0083121041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical