=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568872810
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATERI KALOYANIDES LMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2014
-----------------------------------------------------
Last Update Date | 05/07/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21 GLEN AVE
-----------------------------------------------------
City | CHELMSFORD
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01824-2858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 978-256-0667
-----------------------------------------------------
Fax | 978-256-5567
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 154 BUTTERNUT LN
-----------------------------------------------------
City | METHUEN
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01844-1944
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-759-6257
-----------------------------------------------------
Fax | 978-256-5567
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 0726
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------