Provider Demographics
NPI:1225512197
Name:MANNHEIMER, CATHERINE JANE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JANE
Last Name:MANNHEIMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 FREEMAN STREET EXT
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01832-4659
Mailing Address - Country:US
Mailing Address - Phone:978-204-1016
Mailing Address - Fax:
Practice Address - Street 1:4 NOEL ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3611
Practice Address - Country:US
Practice Address - Phone:978-388-5354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1021148-SW-LICSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical