Provider Demographics
NPI:1285653311
Name:SIMUTIS, CATHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:
Last Name:SIMUTIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CENTRAL AVE SE
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4811
Mailing Address - Country:US
Mailing Address - Phone:505-980-4060
Mailing Address - Fax:
Practice Address - Street 1:1400 CENTRAL AVE SE
Practice Address - Street 2:SUITE 2000
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4811
Practice Address - Country:US
Practice Address - Phone:505-980-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM394103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical