Provider Demographics
NPI:1457685323
Name:BADERTSCHER, KATHERINE FLAVIN (LMHC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:FLAVIN
Last Name:BADERTSCHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 HIGHLAND AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2530
Mailing Address - Country:US
Mailing Address - Phone:617-538-3550
Mailing Address - Fax:617-666-5832
Practice Address - Street 1:403 HIGHLAND AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2530
Practice Address - Country:US
Practice Address - Phone:617-538-3550
Practice Address - Fax:617-666-5832
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4602101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health