Provider Demographics
NPI:1871881672
Name:BIGSBY, KATHRYN HAWKS DE ROECK (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:HAWKS DE ROECK
Last Name:BIGSBY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 ORANGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2210
Mailing Address - Country:US
Mailing Address - Phone:336-782-0844
Mailing Address - Fax:
Practice Address - Street 1:2003 E NC HIGHWAY 54 STE C
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2483
Practice Address - Country:US
Practice Address - Phone:336-782-0844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
NCC0087591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker