Provider Demographics
NPI:1902069248
Name:JAMESON, KATRINA L (LCMHC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:L
Last Name:JAMESON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:L
Other - Last Name:DUGRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:2 WALL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1518
Mailing Address - Country:US
Mailing Address - Phone:603-668-4111
Mailing Address - Fax:603-628-7757
Practice Address - Street 1:2 WALL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1518
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:603-628-7757
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NH1163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator