Provider Demographics
NPI:1558391573
Name:KRONICK, ANN CATHERINE
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CATHERINE
Last Name:KRONICK
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:CATHERINE
Other - Last Name:JORN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:93 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFILED
Mailing Address - State:MA
Mailing Address - Zip Code:01201-3540
Mailing Address - Country:US
Mailing Address - Phone:413-274-4464
Mailing Address - Fax:815-642-4652
Practice Address - Street 1:279 DALTON AVE
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3540
Practice Address - Country:US
Practice Address - Phone:413-274-4464
Practice Address - Fax:815-642-4652
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8079103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAW51226Medicare ID - Type Unspecified