Healthcare Provider Details

I. General information

NPI: 1386225225
Provider Name (Legal Business Name): KATHERINE AUDREY TERHUNE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE AUDREY TERHUNE

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 BROADWAY
SOMERVILLE MA
02145-2935
US

IV. Provider business mailing address

1493 CAMBRIDGE ST
CAMBRIDGE MA
02139-1047
US

V. Phone/Fax

Practice location:
  • Phone: 617-284-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number1019748
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: