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Individual

DR. KATHERINE BOTHOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
170 POST RD, SUITE 208, FAIRFIELD, CT 06824-6242
(203) 445-3736
Mailing address
170 POST RD, SUITE 208, FAIRFIELD, CT 06824-6242
(203) 445-3736

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
002950
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004553
CTBPH/BEACON HEALTH VOPTIONS BOTHS,MD
CT
05
008025366
CT
01
06002950CT02
ANTHEM BCBS OF CT- BOTHOS. MD
CT
01
12099166
CAQH
CT
01
3239811
CIGNA BEHAVIORAL HEALTH BOTHOS, MD
CT
01
PENDING
BEACON HEALTH- VALUE OPTIONS AWAKEN THE POWER THERAPY, LLC
CT
Enumeration date
11/17/2009
Last updated
03/21/2017
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