Healthcare Provider Details

I. General information

NPI: 1629938675
Provider Name (Legal Business Name): KATHLEEN HARNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 COURT ST
UTICA NY
13502-3803
US

IV. Provider business mailing address

119 RODEO DR
UTICA NY
13502-7631
US

V. Phone/Fax

Practice location:
  • Phone: 315-738-4660
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: