Healthcare Provider Details

I. General information

NPI: 1346829397
Provider Name (Legal Business Name): KATHERINE DICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 LINCOLN ST STE 302
WORCESTER MA
01605-3646
US

IV. Provider business mailing address

PO BOX 990770
BOSTON MA
02199-0770
US

V. Phone/Fax

Practice location:
  • Phone: 888-681-2730
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10002692
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: