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General NPI Number Information
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NPI Number | 1124282470
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Entity Type | Individual
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Provider Name | KATHERINE SANDRA HANLEY PMHNP-BC, LMHC
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Gender | Female
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Dates
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Enumeration Date | 07/16/2008
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Last Update Date | 01/22/2020
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Provider Practice Location Address
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Address Line | 30 MEADOWBROOK RD
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City | BROCKTON
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State | MA
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Zip | 02301-7122
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Country | US
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Telephone | 857-225-4076
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Fax | 508-408-6199
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Provider Business Mailing Address
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Address Line | 30 MEADOWBROOK RD
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City | BROCKTON
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State | MA
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Zip | 02301-7122
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Country | US
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Telephone | 857-225-4076
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Fax | 508-408-6199
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2290510
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8236
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN2290510
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License Number State | MA
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