Provider Demographics
NPI:1497925887
Name:SCHRADER, KATHERINE ELINOR (LMHC, LRC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ELINOR
Last Name:SCHRADER
Suffix:
Gender:F
Credentials:LMHC, LRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 NEWBURY ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-1040
Mailing Address - Country:US
Mailing Address - Phone:978-745-6826
Mailing Address - Fax:
Practice Address - Street 1:65 NEWBURY ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1040
Practice Address - Country:US
Practice Address - Phone:978-745-6826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM21234Medicaid