Dillon, Katherine Amanda
Dillon, Katherine Amanda is an sole proprietor health care provider with primary practice located at 625 Portsmith Place Dr , O Fallon IL 62269-7061. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dillon, Katherine Amanda can be contacted via phone (727) 600-5088.Contact Information
Primary practice address
625 Portsmith Place Dr
O Fallon IL 62269-7061
Phone: (727) 600-5088
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2017023531 | Missouri |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149018464 | Illinois |
Profile Details
| NPI number | 1528472974 |
|---|---|
| LBN Legal business name | Dillon, Katherine Amanda |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2014 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528472974 | NPPES |
| South Carolina | MEDICAID | 1760596480 |
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