Provider Demographics
NPI:1730702192
Name:BOGART, KATHRINE ROSE (MSW)
Entity type:Individual
Prefix:
First Name:KATHRINE
Middle Name:ROSE
Last Name:BOGART
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATHRINE
Other - Middle Name:ROSE
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6805 W TOMBSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85743-1056
Mailing Address - Country:US
Mailing Address - Phone:520-808-6316
Mailing Address - Fax:
Practice Address - Street 1:3601 S 6TH AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85723-0001
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker