Provider Demographics
NPI:1861537557
Name:NAUGLE, KATHLEEN E (CSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:NAUGLE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 E STEIN HWY
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-1416
Mailing Address - Country:US
Mailing Address - Phone:302-629-0112
Mailing Address - Fax:302-628-9043
Practice Address - Street 1:306 E STEIN HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1416
Practice Address - Country:US
Practice Address - Phone:302-629-0112
Practice Address - Fax:302-628-9043
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00005171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE00B957O81Medicare PIN