Provider Demographics
NPI:1699815118
Name:COTE, KATHRYN MARIE (LICSW MSSW)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:MARIE
Last Name:COTE
Suffix:
Gender:F
Credentials:LICSW MSSW
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:MARIE
Other - Last Name:KAUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSSW LICSW
Mailing Address - Street 1:190 EASTERN AVE
Mailing Address - Street 2:STE 205
Mailing Address - City:ST JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819-5600
Mailing Address - Country:US
Mailing Address - Phone:802-748-8356
Mailing Address - Fax:
Practice Address - Street 1:190 EASTERN AVE
Practice Address - Street 2:STE 205
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-5600
Practice Address - Country:US
Practice Address - Phone:802-748-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08900008121041C0700X
NH3671041C0700X
CALCS75011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1007687Medicaid
NHRE2217OtherMEDICARE
VTVN2756Medicare ID - Type Unspecified