Provider Demographics
NPI:1821025685
Name:COUTU, KATHLEEN J (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:J
Last Name:COUTU
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 E NORTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01360-9668
Mailing Address - Country:US
Mailing Address - Phone:413-773-0009
Mailing Address - Fax:412-772-0865
Practice Address - Street 1:32 E NORTHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MA
Practice Address - Zip Code:01360-9668
Practice Address - Country:US
Practice Address - Phone:413-773-0009
Practice Address - Fax:412-772-0865
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1066121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA32433OtherHEALTH NEW ENGLAND
MA000000OtherUNITED BEHAVORIAL HEALTH
MAP05922OtherBLUE CROSS BLUE SHIELD
MA2158517OtherCIGNA
MA115927000OtherMAGELLAN