Provider Demographics
NPI:1700889482
Name:WEISBROD, CATHERINE LEE (LICSW,CEAP,BCD)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LEE
Last Name:WEISBROD
Suffix:
Gender:F
Credentials:LICSW,CEAP,BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 ALLSTON ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3917
Mailing Address - Country:US
Mailing Address - Phone:617-492-3868
Mailing Address - Fax:617-547-7304
Practice Address - Street 1:203 ALLSTON ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3917
Practice Address - Country:US
Practice Address - Phone:617-492-3868
Practice Address - Fax:617-547-7304
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2010-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1034391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical