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Individual

MS. KATHERINE WALWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA,BA,LPC

Contact information

Practice address
20 ELM ST, UNIT 2, STONINGTON, CT 06378-1259
(860) 303-7166
Mailing address
58 RIVERS STREET, SUITE 10, MILFORD, CT 06460
(203) 693-1050
(203) 306-3388

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002867
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13863724
CAQH
CT
01
PENDING
CIGNA BEHAVIORAL HEALTH
CT
Enumeration date
02/04/2016
Last updated
08/28/2017
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