Provider Demographics
NPI:1285334672
Name:POWERS, KATE
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:POWERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1267 ELMIRA RD
Mailing Address - Street 2:
Mailing Address - City:NEWFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14867-9280
Mailing Address - Country:US
Mailing Address - Phone:607-592-9790
Mailing Address - Fax:
Practice Address - Street 1:114 SOUTH RD
Practice Address - Street 2:
Practice Address - City:BROOKTONDALE
Practice Address - State:NY
Practice Address - Zip Code:14817-9721
Practice Address - Country:US
Practice Address - Phone:607-391-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP120460101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health