Provider Demographics
NPI:1871872283
Name:LOVE, KATHERINE SCHUTT (MSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SCHUTT
Last Name:LOVE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:EMILY
Other - Last Name:SCHUTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 SUNNYHILLS DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1909
Mailing Address - Country:US
Mailing Address - Phone:415-457-3200
Mailing Address - Fax:
Practice Address - Street 1:300 SUNNYHILLS DR
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-1909
Practice Address - Country:US
Practice Address - Phone:415-457-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-16
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW29179104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker