Provider Demographics
NPI:1730875113
Name:PAYE, KATHLEEN S (LCSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:S
Last Name:PAYE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATI
Other - Middle Name:
Other - Last Name:PAYE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:123 BAILEY RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-1002
Mailing Address - Country:US
Mailing Address - Phone:702-985-4492
Mailing Address - Fax:
Practice Address - Street 1:123 BAILEY RD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-1002
Practice Address - Country:US
Practice Address - Phone:857-304-5939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2291581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical