MEDICARE: MS. KATHLEEN PATRICIA OCHS LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	115469	MA

General Provider Information

NPI Number	:	1003111691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN PATRICIA OCHS LICSW

Provider Business Mailing Address
First Line	:	14 LAKE SHORE CIRCLE DR
Second Line	:
City	:	NASSAU
State	:	NY
Zip	:	12123-2411
Country	:	US
Telephone Number	:	413-822-2073
Fax Number	:

Provider Business Practice Location Address
First Line	:	491 MAIN ST
Second Line	:
City	:	GREAT BARRINGTON
State	:	MA
Zip	:	01230-1856
Country	:	US
Telephone Number	:	413-822-2073
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	01/13/2011

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