MEDICARE: LAURA KALIN LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	9419	MA

General Provider Information

NPI Number	:	1497180483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA KALIN LMHC

Provider Business Mailing Address
First Line	:	1753 MASSACHUSETTS AVE STE 3
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02140-2231
Country	:	US
Telephone Number	:	617-871-9133
Fax Number	:

Provider Business Practice Location Address
First Line	:	1753 MASSACHUSETTS AVE STE 3
Second Line	:
City	:	CAMBRIDGE
State	:	MA
Zip	:	02140-2231
Country	:	US
Telephone Number	:	617-871-9133
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2013
Last Update Date	:	10/21/2020

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