Provider Demographics
NPI:1336269455
Name:KAISER, KATHERINE ANNE (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ANNE
Last Name:KAISER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2332 KATELAND CT
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-3086
Mailing Address - Country:US
Mailing Address - Phone:410-569-0465
Mailing Address - Fax:410-550-1061
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:#D3E
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-0093
Practice Address - Fax:410-550-1061
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1286101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional