Provider Demographics
NPI:1326103268
Name:CLOVER, CATHY L (MA)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:L
Last Name:CLOVER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2722 WILMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-1241
Mailing Address - Country:US
Mailing Address - Phone:724-658-9398
Mailing Address - Fax:724-656-1429
Practice Address - Street 1:2722 WILMINGTON RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16105-1241
Practice Address - Country:US
Practice Address - Phone:724-658-9398
Practice Address - Fax:724-656-1429
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-005964-L103TF0200X, 103TP2701X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01727016Medicaid
PA512968OtherHIGHMARK
1308035OtherCLOVER PSYCH HIGHMARK
PA110119OtherVALUE OPTIONS
PA512968OtherMAGELLAN
PA512968OtherMAGELLAN