Provider Demographics
NPI:1033573860
Name:CARBINE, KATHERINE GEBHARDT (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:GEBHARDT
Last Name:CARBINE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 S MAIN ST UNIT 383
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-7716
Mailing Address - Country:US
Mailing Address - Phone:860-578-8011
Mailing Address - Fax:
Practice Address - Street 1:157 CHARTER OAK AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-1913
Practice Address - Country:US
Practice Address - Phone:860-515-2358
Practice Address - Fax:860-243-4418
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0086691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical