Provider Demographics
NPI:1023614088
Name:MARTINO, KATRINA FRANCES (MED, LMHC)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:FRANCES
Last Name:MARTINO
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:
Other - Last Name:REARDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 DUNDEE PARK DR STE 301
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-3725
Mailing Address - Country:US
Mailing Address - Phone:978-396-9866
Mailing Address - Fax:978-504-2979
Practice Address - Street 1:2 DUNDEE PARK DR STE 301
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3725
Practice Address - Country:US
Practice Address - Phone:978-396-9866
Practice Address - Fax:978-504-2979
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC13430101YM0800X
MA20041101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)