Provider Demographics
NPI:1629116215
Name:COLLINS-WOOLEY, KATHRYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:COLLINS-WOOLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-1362
Mailing Address - Country:US
Mailing Address - Phone:781-749-2089
Mailing Address - Fax:
Practice Address - Street 1:185 LINCOLN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1760
Practice Address - Country:US
Practice Address - Phone:781-749-2089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3888103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3888Medicare UPIN
MAWO3938Medicare UPIN
MAWO3938Medicare ID - Type Unspecified