Provider Demographics
NPI:1508313545
Name:PATRICK, KATHERINE WINTERSMITH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:WINTERSMITH
Last Name:PATRICK
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 1:1359 HANCOCK ST STE 9
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5108
Mailing Address - Country:US
Mailing Address - Phone:617-213-0064
Mailing Address - Fax:
Practice Address - Street 1:1359 HANCOCK ST STE 9
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5108
Practice Address - Country:US
Practice Address - Phone:617-213-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11584103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist