Provider Demographics
NPI:1992001325
Name:HINRICHS, KATE LOUISE MARTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATE
Middle Name:LOUISE MARTIN
Last Name:HINRICHS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:LOUISE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:940 BELMONT ST
Mailing Address - Street 2:VA BOSTON HCS; (GEC-181)
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-5596
Mailing Address - Country:US
Mailing Address - Phone:774-826-3451
Mailing Address - Fax:774-826-2643
Practice Address - Street 1:940 BELMONT ST
Practice Address - Street 2:VA BOSTON HCS; (GEC-181)
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5596
Practice Address - Country:US
Practice Address - Phone:774-826-3451
Practice Address - Fax:774-826-2643
Is Sole Proprietor?:No
Enumeration Date:2011-02-02
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 24064103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist