Basic Information
| Provider Information | |||||||||
| NPI: | 1003139262 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIFRAIA | ||||||||
| FirstName: | KATHY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.ED., LMHC, CCTP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 - 6 WATER STREET | ||||||||
| Address2: | #4 | ||||||||
| City: | AMESBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789928257 | ||||||||
| FaxNumber: | 9787925568 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 WATER ST STE 4 | ||||||||
| Address2: | |||||||||
| City: | AMESBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019132937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9789928257 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/02/2010 | ||||||||
| LastUpdateDate: | 06/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.