Provider Demographics
NPI:1154761344
Name:GREENE, KATHRYN ALANA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ALANA
Last Name:GREENE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02129-3759
Mailing Address - Country:US
Mailing Address - Phone:617-435-1505
Mailing Address - Fax:
Practice Address - Street 1:1093 BEACON ST STE 103
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5623
Practice Address - Country:US
Practice Address - Phone:617-435-1505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-02
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9708103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist