Provider Demographics
NPI:1457467557
Name:JOURNEY, CATHERINE LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:LYNN
Last Name:JOURNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:BRENDA
Other - Middle Name:LYNN
Other - Last Name:REGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 133
Mailing Address - Street 2:
Mailing Address - City:MEXICO
Mailing Address - State:ME
Mailing Address - Zip Code:04257
Mailing Address - Country:US
Mailing Address - Phone:207-364-9991
Mailing Address - Fax:207-364-9940
Practice Address - Street 1:60 LOWELL STREET
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276
Practice Address - Country:US
Practice Address - Phone:207-364-9991
Practice Address - Fax:207-364-9940
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL2897103TP0814X
MEME266176103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis
Provider Identifiers
StateIdentifier IDID TypeIssuer
P05331Medicare UPIN
404100000Medicare ID - Type Unspecified