Provider Demographics
NPI:1710925565
Name:SCHLEICH-MEDEIROS, KATHERINE ANNE (LMHC, LRC, CRC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANNE
Last Name:SCHLEICH-MEDEIROS
Suffix:
Gender:F
Credentials:LMHC, LRC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 HIGHLAND AVE
Mailing Address - Street 2:COMPTON HIGHLANDS
Mailing Address - City:LITTLE COMPTON
Mailing Address - State:RI
Mailing Address - Zip Code:02837-1604
Mailing Address - Country:US
Mailing Address - Phone:401-635-9524
Mailing Address - Fax:401-635-9524
Practice Address - Street 1:92 FAUNCE CORNER RD
Practice Address - Street 2:UNIT 110
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1262
Practice Address - Country:US
Practice Address - Phone:508-994-1109
Practice Address - Fax:508-994-1129
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA176495101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAC-021260OtherREHABILITATION COUNSELOR