Basic Information
Provider Information
NPI: 1306963640
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RICE
FirstName: KATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 180 ACADEMY ST STE 3
Address2:  
City: PRESQUE ISLE
State: ME
PostalCode: 047693183
CountryCode: US
TelephoneNumber: 2075542352
FaxNumber: 2075542351
Practice Location
Address1: 127 PALMER ST
Address2:  
City: CALAIS
State: ME
PostalCode: 046191300
CountryCode: US
TelephoneNumber: 2074540269
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/23/2007
LastUpdateDate: 02/02/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/02/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000XCC2281MEY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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