1740443662 NPI number — MS. KATHARINE MILES WARNER LICSW

Table of content: MS. KATHARINE MILES WARNER LICSW (NPI 1740443662)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740443662 NPI number — MS. KATHARINE MILES WARNER LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARNER
Provider First Name:
KATHARINE
Provider Middle Name:
MILES
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILES
Provider Other First Name:
KATHARINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740443662
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/26/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14 MICA LN STE 103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WELLESLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02481-1708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-221-8389
Provider Business Mailing Address Fax Number:
617-221-9768

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 MICA LN STE 103
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WELLESLEY
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02481-1708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-221-8389
Provider Business Practice Location Address Fax Number:
617-221-9768
Provider Enumeration Date:
07/10/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , registered in the state of NULL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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