Provider Demographics
NPI:1811041353
Name:DESCHENES, KATHLEEN LOUISE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LOUISE
Last Name:DESCHENES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 BEACH AVENUE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-2028
Mailing Address - Country:US
Mailing Address - Phone:860-274-2364
Mailing Address - Fax:860-945-0721
Practice Address - Street 1:51 DEPOT STREET
Practice Address - Street 2:SUITE 209
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2028
Practice Address - Country:US
Practice Address - Phone:860-274-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000592106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist