Provider Demographics
NPI:1720031164
Name:KATSOS, SHARA THERESA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:SHARA
Middle Name:THERESA
Last Name:KATSOS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:SHARA
Other - Middle Name:THERESA
Other - Last Name:KATSOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:200 SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730-1198
Mailing Address - Country:US
Mailing Address - Phone:508-801-8294
Mailing Address - Fax:
Practice Address - Street 1:200 SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730-1198
Practice Address - Country:US
Practice Address - Phone:508-801-8294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1114761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical