MEDICARE: KATRINA L CHASE

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1154169480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA L CHASE

Provider Business Mailing Address
First Line	:	514 NW 7TH CT
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-3627
Country	:	US
Telephone Number	:	561-777-0045
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 W MANGO ST
Second Line	:
City	:	LANTANA
State	:	FL
Zip	:	33462-2835
Country	:	US
Telephone Number	:	561-777-0045
Fax Number	:

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

Provider Enumeration Date	:	07/19/2024
Last Update Date	:	07/19/2024

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Directions to “ KATRINA L CHASE ” Practice Location

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