Provider Demographics
NPI:1275032559
Name:CATCHMARK, ROSE MARY
Entity Type:Individual
Prefix:
First Name:ROSE MARY
Middle Name:
Last Name:CATCHMARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 MATCH FACTORY PL
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1367
Mailing Address - Country:US
Mailing Address - Phone:814-353-3151
Mailing Address - Fax:
Practice Address - Street 1:320 ROLLING RIDGE DR STE 100
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7641
Practice Address - Country:US
Practice Address - Phone:814-867-0670
Practice Address - Fax:814-867-7616
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006260101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional