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General NPI Number Information
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NPI Number | 1356072029
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Entity Type | Individual
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Provider Name | KATHRYN PACE
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Gender | Female
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 113 UNIVERSITY PL # 11C
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City | NEW YORK
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State | NY
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Zip | 10003-4527
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Country | US
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Telephone | 217-721-9990
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Fax |
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Provider Business Mailing Address
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Address Line | 557 W 144TH ST APT 1D
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City | NEW YORK
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State | NY
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Zip | 10031-5756
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Country | US
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Telephone | 845-768-3585
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 116409
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License Number State | NY
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