Provider Demographics
NPI:1821156589
Name:CLARKE, KATHRINE LYNN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATHRINE
Middle Name:LYNN
Last Name:CLARKE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KATHRINE
Other - Middle Name:
Other - Last Name:KENNEDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4 QUAIL MEADOW MANE
Mailing Address - Street 2:
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335
Mailing Address - Country:US
Mailing Address - Phone:860-405-4844
Mailing Address - Fax:
Practice Address - Street 1:34 WATER ST STE 2B
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-2524
Practice Address - Country:US
Practice Address - Phone:860-405-4855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001298106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist