Provider Demographics
NPI:1831340009
Name:CODY, KATHERINE MARIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:MARIA
Last Name:CODY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 5TH AVE
Mailing Address - Street 2:SUITE 1003
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6601
Mailing Address - Country:US
Mailing Address - Phone:917-512-7751
Mailing Address - Fax:
Practice Address - Street 1:303 5TH AVE
Practice Address - Street 2:SUITE 1003
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6601
Practice Address - Country:US
Practice Address - Phone:917-512-7751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019070103TC0700X
CT003354103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical