Provider Demographics
NPI:1821120734
Name:FATINA, CATHERINE (MSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:FATINA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GREENLEAF WOODS DR UNIT 302
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5437
Mailing Address - Country:US
Mailing Address - Phone:603-431-2033
Mailing Address - Fax:
Practice Address - Street 1:1 GREENLEAF WOODS DR UNIT 302
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5437
Practice Address - Country:US
Practice Address - Phone:603-431-2033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH LICENSE # 1161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV30007166Medicaid
NV30007166Medicaid