Provider Demographics
NPI:1275632960
Name:GAW, CATHERINE A (PSYD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:GAW
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2785 SOM CENTER RD
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-6501
Mailing Address - Country:US
Mailing Address - Phone:440-602-8601
Mailing Address - Fax:440-602-8619
Practice Address - Street 1:2785 SOM CENTER RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-6501
Practice Address - Country:US
Practice Address - Phone:440-602-8601
Practice Address - Fax:440-602-8619
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1546-57103TC0700X
OH5487103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2164634Medicaid
OHGACP79511Medicare PIN
OHR60525Medicare UPIN