Healthcare Provider Details

I. General information

NPI: 1174815666
Provider Name (Legal Business Name): KATE NYE LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE STROMBERG LCSW

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 BELMONT ST
WORCESTER MA
01604-1019
US

IV. Provider business mailing address

16A NUMBER 10 SCHOOLHOUSE RD
CHARLTON MA
01507-5300
US

V. Phone/Fax

Practice location:
  • Phone: 413-564-9654
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118245
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number118245
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: