Provider Demographics
NPI:1164781332
Name:TATEVOSYAN, CATHERINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:TATEVOSYAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:SADELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:292 MAIN ST APT G
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-2348
Mailing Address - Country:US
Mailing Address - Phone:917-566-2209
Mailing Address - Fax:
Practice Address - Street 1:292 MAIN ST APT G
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:NJ
Practice Address - Zip Code:07940-2348
Practice Address - Country:US
Practice Address - Phone:917-566-2209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0826401041C0700X
NJ44SC058579001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical