Healthcare Provider Details

I. General information

NPI: 1215857180
Provider Name (Legal Business Name): KATHRYN SLATER LICSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 MAIN ST
HARWICH MA
02645-2315
US

IV. Provider business mailing address

191 MAIN ST
HARWICH MA
02645-2315
US

V. Phone/Fax

Practice location:
  • Phone: 774-212-0639
  • Fax:
Mailing address:
  • Phone: 774-212-0639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN SLATER
Title or Position: LICSW
Credential:
Phone: 774-212-0693