Provider Demographics
NPI:1467029272
Name:WILLERT, KATHERINE PERATIS (MHC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PERATIS
Last Name:WILLERT
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 1:334 W 85TH ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3817
Mailing Address - Country:US
Mailing Address - Phone:646-634-6629
Mailing Address - Fax:
Practice Address - Street 1:334 W 85TH ST APT 5A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3817
Practice Address - Country:US
Practice Address - Phone:646-634-6629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health