Provider Demographics
NPI:1063723542
Name:DARE-WINTERS, KATE (LICSW)
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:
Last Name:DARE-WINTERS
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 1:58 ARBORWAY
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2717
Mailing Address - Country:US
Mailing Address - Phone:617-224-2985
Mailing Address - Fax:
Practice Address - Street 1:930 MASS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3234
Practice Address - Country:US
Practice Address - Phone:617-224-2985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASW10240721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical