Provider Demographics
NPI:1144536871
Name:ADDLESON, KATHARINE THOMAS (LICSW)
Entity type:Individual
Prefix:MRS
First Name:KATHARINE
Middle Name:THOMAS
Last Name:ADDLESON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUMMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01026-9742
Mailing Address - Country:US
Mailing Address - Phone:978-879-7319
Mailing Address - Fax:
Practice Address - Street 1:1 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-6003
Practice Address - Country:US
Practice Address - Phone:802-440-4459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health