Provider Demographics
NPI:1417435140
Name:ZWEIFEL, KATIE AGUAYO (LICSW, PMH-C)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:AGUAYO
Last Name:ZWEIFEL
Suffix:
Gender:F
Credentials:LICSW, PMH-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 MAIN ST STE 9
Mailing Address - Street 2:
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-4068
Mailing Address - Country:US
Mailing Address - Phone:617-855-9289
Mailing Address - Fax:
Practice Address - Street 1:246 MAIN ST STE 9
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-4068
Practice Address - Country:US
Practice Address - Phone:617-855-9289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC224371041C0700X
MA1231321041C0700X
VT089.01346501041C0700X
IL149.0246481041C0700X
NH37591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical