Provider Demographics
NPI:1437965761
Name:ROCHE, KATHERINE ANN (LICSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ANN
Last Name:ROCHE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 FARNHAM ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02119-2962
Mailing Address - Country:US
Mailing Address - Phone:978-257-4131
Mailing Address - Fax:
Practice Address - Street 1:8 FARNHAM ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-2962
Practice Address - Country:US
Practice Address - Phone:781-819-4059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228448104100000X
MA11216701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker