Provider Demographics
NPI:1306328687
Name:WILLIAMS, KATHARINE KENNEDY (PHD)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:KENNEDY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 7TH AVE FL 12
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6995
Mailing Address - Country:US
Mailing Address - Phone:212-604-1701
Mailing Address - Fax:212-604-1750
Practice Address - Street 1:275 7TH AVE FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-604-1701
Practice Address - Fax:212-604-1750
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-03
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0226261103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical