Provider Demographics
NPI:1194248617
Name:LAURETANO, KATHERINE PHELPS (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PHELPS
Last Name:LAURETANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 GOODHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-2214
Mailing Address - Country:US
Mailing Address - Phone:860-307-2776
Mailing Address - Fax:
Practice Address - Street 1:66 GOODHOUSE RD
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-2214
Practice Address - Country:US
Practice Address - Phone:860-307-2776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
CT003218101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional