Allen, Katherine Lora Blackstone

Allen, Katherine Lora Blackstone is an individual health care provider with primary practice located at 910 16Th Ave Ste 120 , Longview WA 98632-2374. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Allen, Katherine Lora Blackstone can be contacted via phone (360) 200-5419.

Contact Information

Primary practice address
910 16Th Ave Ste 120 Longview WA 98632-2374
Phone: (360) 200-5419
Fax: (360) 200-6736
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X LW60424218 Washington
Behavioral Health & Social Service Providers / Clinical 1041C0700X LW60424218 Washington

Profile Details

NPI number 1477785541
LBN Legal business name Allen, Katherine Lora Blackstone
Credentials LICSW, MHP, CMHS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2009
Last updated Sep 18th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477785541 NPPES
Washington MEDICAID 2122309

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