Provider Demographics
NPI:1275662363
Name:LOEF, KATRINA V (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:V
Last Name:LOEF
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2079
Mailing Address - Country:US
Mailing Address - Phone:207-797-8552
Mailing Address - Fax:
Practice Address - Street 1:171 AUBURN ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-2131
Practice Address - Country:US
Practice Address - Phone:207-874-8150
Practice Address - Fax:207-874-8272
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional