Provider Demographics
NPI:1861721185
Name:LAWRENCE, KATHERINE MARTIN (LCPC)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARTIN
Last Name:LAWRENCE
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 1:209 CHADSEY RD
Mailing Address - Street 2:
Mailing Address - City:POWNAL
Mailing Address - State:ME
Mailing Address - Zip Code:04069-6054
Mailing Address - Country:US
Mailing Address - Phone:207-688-4494
Mailing Address - Fax:207-688-6515
Practice Address - Street 1:209 CHADSEY RD
Practice Address - Street 2:
Practice Address - City:POWNAL
Practice Address - State:ME
Practice Address - Zip Code:04069-6054
Practice Address - Country:US
Practice Address - Phone:207-688-4494
Practice Address - Fax:207-688-6515
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health