Provider Demographics
NPI:1033722400
Name:WOOD, CATHERINE LEE (LICSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LEE
Last Name:WOOD
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 WATERSIDE CT
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-5627
Mailing Address - Country:US
Mailing Address - Phone:304-963-2455
Mailing Address - Fax:
Practice Address - Street 1:67 WATERSIDE CT
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-5627
Practice Address - Country:US
Practice Address - Phone:304-963-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP009445261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical