Provider Demographics
NPI:1346618451
Name:WENTWORTH, KATHERINE (MHC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:WENTWORTH
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 SALZEDO ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4319
Mailing Address - Country:US
Mailing Address - Phone:954-743-0364
Mailing Address - Fax:
Practice Address - Street 1:5545 SW 8TH ST
Practice Address - Street 2:SUITE 206
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2274
Practice Address - Country:US
Practice Address - Phone:786-762-2952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-04
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health