Provider Demographics
NPI:1215250816
Name:WARE, CATHERINE G (MA, LMHC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:G
Last Name:WARE
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1895 CENTRE ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-1933
Mailing Address - Country:US
Mailing Address - Phone:617-455-9372
Mailing Address - Fax:
Practice Address - Street 1:1895 CENTRE ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1933
Practice Address - Country:US
Practice Address - Phone:617-455-9372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3747101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health