| Organization Name: | KATHLEEN RAPP, LICENSED CLINICAL SOCIAL WORKER A PC |
| NPI Number: | 1063874014 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KATHLEEN RAPP (CEO) |
| Mailing Address: | 767 Academy Dr Solana Beach |
| State: | CA US |
| Postal Code: | 920752031 |
| Phone Number: | 8587934580 |
| Fax Number: | 8587934406 |
| NPI Enumeration Date: | 03/28/2016 |
| NPI Last Update Date: | 04/20/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LCS12202 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |