Provider Demographics
NPI:1073068953
Name:ARCHER, CATHERINE (MAC, LCPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:ARCHER
Suffix:
Gender:F
Credentials:MAC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:973 FEATHERSTONE RD STE 360
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-5908
Mailing Address - Country:US
Mailing Address - Phone:312-612-0938
Mailing Address - Fax:
Practice Address - Street 1:973 FEATHERSTONE RD STE 360
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-5908
Practice Address - Country:US
Practice Address - Phone:312-612-0938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.009784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional