Provider Demographics
NPI:1548928153
Name:PIKE, KATHERINE S (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:S
Last Name:PIKE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 CAPTAIN PARKER ARMS APT 22
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7061
Mailing Address - Country:US
Mailing Address - Phone:617-240-2020
Mailing Address - Fax:
Practice Address - Street 1:333 WYMAN ST STE 100
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-1272
Practice Address - Country:US
Practice Address - Phone:888-283-1722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2017136104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker