Provider Demographics
NPI:1174818876
Name:PINKUS, KATE (LCSW)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:PINKUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:ENGELHARDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:385 HAYLEDGE CT
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-4309
Mailing Address - Country:US
Mailing Address - Phone:860-690-1384
Mailing Address - Fax:
Practice Address - Street 1:675 MAIN STREET
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457
Practice Address - Country:US
Practice Address - Phone:860-347-6971
Practice Address - Fax:860-343-7379
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CT85481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health