Provider Demographics
NPI:1942947023
Name:KRISTEN CATLIN, LICSW CONSULTING INC
Entity Type:Organization
Organization Name:KRISTEN CATLIN, LICSW CONSULTING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:857-217-2014
Mailing Address - Street 1:116 E HOWARD ST APT 525
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-8784
Mailing Address - Country:US
Mailing Address - Phone:339-204-3225
Mailing Address - Fax:
Practice Address - Street 1:116 E HOWARD ST APT 525
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-8784
Practice Address - Country:US
Practice Address - Phone:857-217-2014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1245673128Medicaid