Provider Demographics
NPI:1629377601
Name:AMDAHL, KARI (MA)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:AMDAHL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 DIVISION STREET
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-528-6121
Mailing Address - Fax:
Practice Address - Street 1:174 DIVISION ST
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1179
Practice Address - Country:US
Practice Address - Phone:413-528-6121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health