Provider Demographics
NPI:1467968495
Name:MACLEAN, KATHERINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:MACLEAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 CONNECTICUT AVE NW STE 500
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1123
Mailing Address - Country:US
Mailing Address - Phone:919-260-8559
Mailing Address - Fax:
Practice Address - Street 1:1555 CONNECTICUT AVE NW STE 500
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-652-1307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-28
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05787103T00000X
DCPSY1001272103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist