Provider Demographics
NPI:1538465034
Name:SAPADIN, KATHERINE BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:BETH
Last Name:SAPADIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11020 71ST RD APT 717
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4903
Mailing Address - Country:US
Mailing Address - Phone:718-268-0476
Mailing Address - Fax:
Practice Address - Street 1:11241 QUEENS BLVD
Practice Address - Street 2:100
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7475
Practice Address - Country:US
Practice Address - Phone:718-544-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017489103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling