Provider Demographics
NPI:1518247279
Name:SCHROEDER NOTHAFT, KARIN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:
Last Name:SCHROEDER NOTHAFT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SHADE ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02421-7720
Mailing Address - Country:US
Mailing Address - Phone:617-504-5598
Mailing Address - Fax:
Practice Address - Street 1:20 MUZZEY ST STE 3
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02421-5212
Practice Address - Country:US
Practice Address - Phone:617-504-5598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.007125101Y00000X
MA9219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor