Provider Demographics
NPI:1275213548
Name:CATHERWOOD, KELSEY (LCMHCA)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:CATHERWOOD
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 E 6TH ST STE 307
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2970
Mailing Address - Country:US
Mailing Address - Phone:704-797-6281
Mailing Address - Fax:
Practice Address - Street 1:747 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-1118
Practice Address - Country:US
Practice Address - Phone:336-443-0809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18916101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health