Provider Demographics
NPI:1386037414
Name:CATANIA, CHARLES (EDD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:
Last Name:CATANIA
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W NATIONAL RD
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45315-9508
Mailing Address - Country:US
Mailing Address - Phone:937-479-2941
Mailing Address - Fax:
Practice Address - Street 1:1100 W NATIONAL RD
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45315-9508
Practice Address - Country:US
Practice Address - Phone:937-479-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHMM1018251103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool