Provider Demographics
NPI:1649678178
Name:KINSELLA, KATHERINE (EDD, LMFT, LMHC)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:
Last Name:KINSELLA
Suffix:
Gender:F
Credentials:EDD, LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 PAWTUXET TER
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-5212
Mailing Address - Country:US
Mailing Address - Phone:843-696-6221
Mailing Address - Fax:
Practice Address - Street 1:2348 POST RD
Practice Address - Street 2:STE 107
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2258
Practice Address - Country:US
Practice Address - Phone:401-447-9127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00885101YP2500X
SC4649106H00000X
RIMFT00179106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional