Provider Demographics
NPI:1205818424
Name:CATAWBA COUNSELING ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:CATAWBA COUNSELING ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:A
Authorized Official - Last Name:PENDERGAST
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:704-829-2005
Mailing Address - Street 1:100 GLENWAY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3114
Mailing Address - Country:US
Mailing Address - Phone:704-829-2005
Mailing Address - Fax:
Practice Address - Street 1:100 GLENWAY ST
Practice Address - Street 2:SUITE B
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3114
Practice Address - Country:US
Practice Address - Phone:704-829-2005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0031561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2871963AMedicare ID - Type Unspecified