Provider Demographics
NPI:1023393410
Name:CATHY SHOWFETY INC.
Entity Type:Organization
Organization Name:CATHY SHOWFETY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/MENTAL HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHOWFETY
Authorized Official - Suffix:
Authorized Official - Credentials:APRN,MSN,CSN
Authorized Official - Phone:336-324-3739
Mailing Address - Street 1:1903 DICKENS DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-2217
Mailing Address - Country:US
Mailing Address - Phone:336-324-3739
Mailing Address - Fax:336-632-3503
Practice Address - Street 1:408 1/2 STATE ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5657
Practice Address - Country:US
Practice Address - Phone:336-324-3739
Practice Address - Fax:336-632-3503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68904364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6004061Medicaid
NC97788OtherBCBS
NC97788OtherBCBS