Provider Demographics
NPI:1164867859
Name:ORT, KATHRYN J (MHC)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:J
Last Name:ORT
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:80 STATE HIGHWAY 310
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1493
Mailing Address - Country:US
Mailing Address - Phone:315-386-2167
Mailing Address - Fax:315-286-2435
Practice Address - Street 1:80 STATE HIGHWAY 310
Practice Address - Street 2:SUITE 1
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1493
Practice Address - Country:US
Practice Address - Phone:315-386-2167
Practice Address - Fax:315-386-2435
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYP86749101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health