Healthcare Provider Details

I. General information

NPI: 1184535742
Provider Name (Legal Business Name): KATHERINE MANION MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 VICTORY RD
BOSTON MA
02122-3518
US

IV. Provider business mailing address

48 EUSTIS ST APT 6
CAMBRIDGE MA
02140-2219
US

V. Phone/Fax

Practice location:
  • Phone: 617-371-3000
  • Fax:
Mailing address:
  • Phone: 617-371-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: