Provider Demographics
NPI:1326243460
Name:PORCELLI, KATHERINE (MSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:PORCELLI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:85 LAKEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH HERO
Mailing Address - State:VT
Mailing Address - Zip Code:05486-4601
Mailing Address - Country:US
Mailing Address - Phone:202-617-1546
Mailing Address - Fax:
Practice Address - Street 1:5138 SHELBURNE RD STE 12
Practice Address - Street 2:
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482-6698
Practice Address - Country:US
Practice Address - Phone:802-865-3450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.01359311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical