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NPI Code Detail

MEDICARE: KATHERINE BRODSKY MSW, LICSW

MEDICARE: KATHERINE BRODSKY MSW, LICSW
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
1101YM0800XMental Health Counselor132NH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306995006
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE BRODSKY MSW, LICSW
Provider Business Mailing Address
First Line : 66 PROSPECT ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-3506
Country : US
Telephone Number : 603-668-1975
Fax Number : 603-666-0804
Provider Business Practice Location Address
First Line : 66 PROSPECT ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-3506
Country : US
Telephone Number : 603-668-1975
Fax Number : 603-666-0804
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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