Provider Demographics
NPI:1457843039
Name:GEMEINHARDT, KARIN G (LICSW)
Entity Type:Individual
Prefix:
First Name:KARIN
Middle Name:G
Last Name:GEMEINHARDT
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 REDFIELD ST STE 300
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02122-3653
Mailing Address - Country:US
Mailing Address - Phone:617-264-5368
Mailing Address - Fax:617-232-7925
Practice Address - Street 1:50 REDFIELD ST STE 300
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02122-3653
Practice Address - Country:US
Practice Address - Phone:617-264-5368
Practice Address - Fax:617-232-7925
Is Sole Proprietor?:No
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10256421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical