Provider Demographics
NPI:1386132793
Name:KATHLEEN SCHUSTER PSYD PLLC
Entity type:Organization
Organization Name:KATHLEEN SCHUSTER PSYD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:SCHUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-383-0714
Mailing Address - Street 1:206 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-3664
Mailing Address - Country:US
Mailing Address - Phone:773-383-0714
Mailing Address - Fax:
Practice Address - Street 1:85 WEST ST
Practice Address - Street 2:
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-1844
Practice Address - Country:US
Practice Address - Phone:508-951-0847
Practice Address - Fax:508-921-4613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-01
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10788103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty