Provider Demographics
NPI:1396848743
Name:MCLEOD, CATHERINE HAMMOND (LICENSED CLINICAL SO)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:HAMMOND
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:LICENSED CLINICAL SO
Other - Prefix:
Other - First Name:TRINA
Other - Middle Name:H
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:101 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-6732
Mailing Address - Country:US
Mailing Address - Phone:423-510-1999
Mailing Address - Fax:423-510-1888
Practice Address - Street 1:101 JORDAN DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6732
Practice Address - Country:US
Practice Address - Phone:423-510-1999
Practice Address - Fax:423-510-1888
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000040001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3147599OtherBCBS TN
TNTN4000OtherLICENSE
TN3853952Medicare PIN