Provider Demographics
NPI:1881849107
Name:THACHER, KATE ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:ANNE
Last Name:THACHER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 W 25TH ST FL 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-7470
Mailing Address - Country:US
Mailing Address - Phone:646-380-6119
Mailing Address - Fax:
Practice Address - Street 1:138 W 25TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7470
Practice Address - Country:US
Practice Address - Phone:646-380-6119
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY22332103TC0700X
NY018577-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical