Provider Demographics
NPI:1497938559
Name:SKRABACZ, KATHLEEN E (LADC)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:E
Last Name:SKRABACZ
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214B THAMES
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340
Mailing Address - Country:US
Mailing Address - Phone:860-449-1382
Mailing Address - Fax:860-449-1384
Practice Address - Street 1:214B THAMES ST.
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340
Practice Address - Country:US
Practice Address - Phone:860-449-1382
Practice Address - Fax:860-449-1384
Is Sole Proprietor?:No
Enumeration Date:2007-12-12
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000300101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)