Provider Demographics
NPI:1518297043
Name:BASILE, CATHERINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:BASILE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 W 12TH ST
Mailing Address - Street 2:1B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8564
Mailing Address - Country:US
Mailing Address - Phone:212-741-6343
Mailing Address - Fax:
Practice Address - Street 1:71 W 12TH ST
Practice Address - Street 2:1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8564
Practice Address - Country:US
Practice Address - Phone:212-741-6343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014822103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical