Provider Demographics
NPI:1194964098
Name:CHESSON, KATHERINE ANNE (MSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANNE
Last Name:CHESSON
Suffix:
Gender:
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 W BROAD ST
Mailing Address - Street 2:
Mailing Address - City:PAWCATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06379-4306
Mailing Address - Country:US
Mailing Address - Phone:401-219-1133
Mailing Address - Fax:
Practice Address - Street 1:43 W BROAD ST UNIT 1
Practice Address - Street 2:
Practice Address - City:PAWCATUCK
Practice Address - State:CT
Practice Address - Zip Code:06379-4307
Practice Address - Country:US
Practice Address - Phone:401-219-1133
Practice Address - Fax:401-596-1826
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-17
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008034891Medicaid
RI601201821Medicaid