Provider Demographics
NPI:1023323292
Name:MAYERS, KATHARINE ELLIOTT (LICSW)
Entity type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:ELLIOTT
Last Name:MAYERS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MS
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:22 MILL ST
Mailing Address - Street 2:STE 306
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-4784
Mailing Address - Country:US
Mailing Address - Phone:781-643-0610
Mailing Address - Fax:781-643-0609
Practice Address - Street 1:22 MILL ST
Practice Address - Street 2:STE 306
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4784
Practice Address - Country:US
Practice Address - Phone:781-643-0610
Practice Address - Fax:781-643-0609
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1121091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical