Provider Demographics
NPI:1124121744
Name:MICHAUD, KATHLEEN J (LMHC)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:J
Last Name:MICHAUD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:500 VICTORY RD
Mailing Address - Street 2:SOUTH SHORE MENTAL HEALTH
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02171
Mailing Address - Country:US
Mailing Address - Phone:617-847-1950
Mailing Address - Fax:617-774-1490
Practice Address - Street 1:572 W MAIN ST
Practice Address - Street 2:PARE & ASSOCIATES
Practice Address - City:YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673
Practice Address - Country:US
Practice Address - Phone:508-775-0719
Practice Address - Fax:508-775-5309
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4467101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor