Provider Demographics
NPI:1043885403
Name:KATHLEEN NARDELLA AND ASSOCIATES LLC
Entity Type:Organization
Organization Name:KATHLEEN NARDELLA AND ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:NARDELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C LICSW
Authorized Official - Phone:301-775-5373
Mailing Address - Street 1:1280 CENTRE ST STE 220
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTER
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1553
Mailing Address - Country:US
Mailing Address - Phone:301-775-5373
Mailing Address - Fax:
Practice Address - Street 1:1280 CENTRE ST STE 220
Practice Address - Street 2:
Practice Address - City:NEWTON CENTER
Practice Address - State:MA
Practice Address - Zip Code:02459-1553
Practice Address - Country:US
Practice Address - Phone:301-775-5373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty