Provider Demographics
NPI:1427824697
Name:CORTES AMBROSIO, KATHERINE (MSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:CORTES AMBROSIO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6157
Mailing Address - Country:US
Mailing Address - Phone:413-629-1251
Mailing Address - Fax:
Practice Address - Street 1:86 BRODIE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTOWN
Practice Address - State:MA
Practice Address - Zip Code:01267-9714
Practice Address - Country:US
Practice Address - Phone:413-200-0454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229939101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health