Provider Demographics
NPI:1083190821
Name:PEDEVILLANO, CATHY (LMHC, MA, MS)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:PEDEVILLANO
Suffix:
Gender:F
Credentials:LMHC, MA, MS
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:PEDEVILLANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC, MA, MS
Mailing Address - Street 1:33 E TAYLOR HILL RD
Mailing Address - Street 2:
Mailing Address - City:MONTAGUE
Mailing Address - State:MA
Mailing Address - Zip Code:01351-9508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 ADAMS ST APT B
Practice Address - Street 2:
Practice Address - City:LAKE PLEASANT
Practice Address - State:MA
Practice Address - Zip Code:01347-9802
Practice Address - Country:US
Practice Address - Phone:978-855-0688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health