Provider Demographics
NPI:1194964098
Name:CHESSON, KATHERINE ANNE (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANNE
Last Name:CHESSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 HIGH ST STE 6
Mailing Address - Street 2:
Mailing Address - City:WESTERLY
Mailing Address - State:RI
Mailing Address - Zip Code:02891-1850
Mailing Address - Country:US
Mailing Address - Phone:401-219-1133
Mailing Address - Fax:401-596-1826
Practice Address - Street 1:16 HIGH ST STE 6
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891
Practice Address - Country:US
Practice Address - Phone:401-219-1133
Practice Address - Fax:401-596-1826
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008034891Medicaid
RI601201821Medicaid