Provider Demographics
NPI:1689099442
Name:MONTAGUE, KATHERINE DIFILLIPPO (LICSW MSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:DIFILLIPPO
Last Name:MONTAGUE
Suffix:
Gender:F
Credentials:LICSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 KRISTIN RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4940
Mailing Address - Country:US
Mailing Address - Phone:617-955-6358
Mailing Address - Fax:617-890-6848
Practice Address - Street 1:17 KRISTIN RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4940
Practice Address - Country:US
Practice Address - Phone:617-955-6358
Practice Address - Fax:617-890-6848
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1201231041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical