Provider Demographics
NPI:1336703784
Name:SCHIFFMAN, KATHLEEN MANON (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MANON
Last Name:SCHIFFMAN
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 BEACON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-1295
Mailing Address - Country:US
Mailing Address - Phone:857-233-2189
Mailing Address - Fax:617-249-1937
Practice Address - Street 1:262 BEACON ST STE 3
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-1295
Practice Address - Country:US
Practice Address - Phone:857-233-2189
Practice Address - Fax:617-249-1937
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11018101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health