Provider Demographics
NPI:1679343347
Name:PHILBRICK, KATERINA (LPCA)
Entity Type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:PHILBRICK
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 COUNTY RD # 151
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1058
Mailing Address - Country:US
Mailing Address - Phone:203-533-9021
Mailing Address - Fax:
Practice Address - Street 1:151 COUNTY RD # 151
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-1058
Practice Address - Country:US
Practice Address - Phone:203-533-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6854101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health