Healthcare Provider Details

I. General information

NPI: 1932280773
Provider Name (Legal Business Name): KATHERINE MELISSA PUTNAM PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 09/20/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 LATHROP ST
SOUTH HADLEY MA
01075-1727
US

IV. Provider business mailing address

175 LATHROP ST
SOUTH HADLEY MA
01075-1727
US

V. Phone/Fax

Practice location:
  • Phone: 413-450-2847
  • Fax: 413-450-2847
Mailing address:
  • Phone: 413-450-2847
  • Fax: 413-450-2847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10860
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: