Provider Demographics
NPI:1508909839
Name:CATHOLIC CHARITIES OF NORTHWEST
Entity Type:Organization
Organization Name:CATHOLIC CHARITIES OF NORTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELING PROGRAM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-436-6412
Mailing Address - Street 1:218 E GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-6019
Mailing Address - Country:US
Mailing Address - Phone:850-436-6412
Mailing Address - Fax:850-436-6414
Practice Address - Street 1:218 E GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6019
Practice Address - Country:US
Practice Address - Phone:850-436-6412
Practice Address - Fax:850-436-6414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6295101YM0800X
FLMH 8382101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty