Provider Demographics
NPI:1922332816
Name:DOAN, KATHRYN (LICSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DOAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02302-3133
Mailing Address - Country:US
Mailing Address - Phone:508-232-6567
Mailing Address - Fax:508-588-5751
Practice Address - Street 1:103 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3133
Practice Address - Country:US
Practice Address - Phone:508-322-6567
Practice Address - Fax:508-588-5751
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health