Provider Demographics
NPI:1669056644
Name:PANCIONE, KATHERINE MARY (MA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MARY
Last Name:PANCIONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 CAMBERWELL CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2981
Mailing Address - Country:US
Mailing Address - Phone:703-966-8924
Mailing Address - Fax:
Practice Address - Street 1:2507 CAMBERWELL CT
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2981
Practice Address - Country:US
Practice Address - Phone:703-966-8924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health