Provider Demographics
NPI:1801186879
Name:HAAS, CATHERINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:HAAS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:OOOOOOOOOOOOOOOOOOOOOO
Mailing Address - Street 2:
Mailing Address - City:000000000000000000
Mailing Address - State:OOOOOOOOOOOOO
Mailing Address - Zip Code:000000000000
Mailing Address - Country:AF
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 OCEAN AVE
Practice Address - Street 2:OCEAN AVE. ELEM OCEAN AVENUE ELEMENTARY SCHOOL
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-0000
Practice Address - Country:US
Practice Address - Phone:207-874-8180
Practice Address - Fax:207-874-1021
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-12
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC27141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical