Provider Demographics
NPI:1992155634
Name:ELKINGTON, KATHERINE (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:ELKINGTON
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 1:1051 RIVERSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1007
Mailing Address - Country:US
Mailing Address - Phone:646-774-6965
Mailing Address - Fax:
Practice Address - Street 1:1051 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1007
Practice Address - Country:US
Practice Address - Phone:646-774-6965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071484-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist