Provider Demographics
NPI:1780493627
Name:PANNONE, KATHERINE CECELIA (LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CECELIA
Last Name:PANNONE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:KATHERINE
Other - Middle Name:CECELIA
Other - Last Name:NEUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:100 KENYON AVE
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4216
Mailing Address - Country:US
Mailing Address - Phone:401-782-8000
Mailing Address - Fax:401-782-9867
Practice Address - Street 1:100 KENYON AVE
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:RI
Practice Address - Zip Code:02879-4216
Practice Address - Country:US
Practice Address - Phone:401-782-8000
Practice Address - Fax:401-782-9867
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICSW024601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical