Provider Demographics
NPI:1407102783
Name:SEVERSON, CATHARINA ELISABET (MS, MFT)
Entity Type:Individual
Prefix:MISS
First Name:CATHARINA
Middle Name:ELISABET
Last Name:SEVERSON
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:CATHARINA
Other - Middle Name:
Other - Last Name:FORSYTHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:68 COOMBS ST STE A-1
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3956
Mailing Address - Country:US
Mailing Address - Phone:415-787-3414
Mailing Address - Fax:
Practice Address - Street 1:68 COOMBS ST STE A-1
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-3956
Practice Address - Country:US
Practice Address - Phone:415-787-3414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53054106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist