Provider Demographics
NPI:1083320410
Name:JAMISON, KATHERINE (PRE-LICENSED LMHC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:JAMISON
Suffix:
Gender:F
Credentials:PRE-LICENSED LMHC
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:JAMISON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PRE-LICENSED LMHC
Mailing Address - Street 1:316 BERGEN ST APT 209
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2096
Mailing Address - Country:US
Mailing Address - Phone:619-456-5084
Mailing Address - Fax:
Practice Address - Street 1:302 5TH AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3604
Practice Address - Country:US
Practice Address - Phone:619-456-5084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health