Provider Demographics
NPI:1821601188
Name:STAHL, KATHERINE MAY (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAY
Last Name:STAHL
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 1:119 JOSEPHINE AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2252
Mailing Address - Country:US
Mailing Address - Phone:781-879-0477
Mailing Address - Fax:
Practice Address - Street 1:119 JOSEPHINE AVE APT 3
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2252
Practice Address - Country:US
Practice Address - Phone:781-879-0477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA13502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health