Provider Demographics
NPI:1174959647
Name:WILSON, KATHRYN M (MS, LMHC)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:M
Last Name:WILSON
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:M
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:70 CROTON AVE APT 1L
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-7907
Mailing Address - Country:US
Mailing Address - Phone:631-965-0847
Mailing Address - Fax:
Practice Address - Street 1:70 CROTON AVE APT 1L
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-7907
Practice Address - Country:US
Practice Address - Phone:631-965-0847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY007608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health