Provider Demographics
NPI:1811043508
Name:BESERRA, KARI ELIZABETH (LMHC)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:ELIZABETH
Last Name:BESERRA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 WALDEN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3614
Mailing Address - Country:US
Mailing Address - Phone:978-369-7611
Mailing Address - Fax:978-371-1578
Practice Address - Street 1:148 WALDEN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3614
Practice Address - Country:US
Practice Address - Phone:978-369-7611
Practice Address - Fax:978-371-1578
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health