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General NPI Number Information
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NPI Number | 1285333633
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Entity Type | Organization
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Legal Business Name | KATELYN ANDERSON LICSW
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Dates
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Enumeration Date | 02/24/2023
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Last Update Date | 02/24/2023
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Provider Practice Location Address
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Address Line | 35 VILLAGE RD STE 100
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City | MIDDLETON
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State | MA
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Zip | 01949-1238
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Country | US
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Telephone | 781-258-2538
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Fax |
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Provider Business Mailing Address
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Address Line | 165 CARTER ST
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City | TEWKSBURY
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State | MA
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Zip | 01876-1407
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Country | US
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Telephone | 781-258-2538
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Fax |
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Authorized Official
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Title or Position | INDEPENDENTLY LICENSED THERAPIST
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Name | MRS. KATELYN KIM ANDERSON
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Credential | LICSW
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Telephone | 781-258-2538
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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