Provider Demographics
NPI:1518598150
Name:HAGWOOD, CATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:HAGWOOD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 CHARMANT PL STE 1
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4358
Mailing Address - Country:US
Mailing Address - Phone:601-850-7047
Mailing Address - Fax:
Practice Address - Street 1:199 CHARMANT PL STE 1
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4358
Practice Address - Country:US
Practice Address - Phone:601-850-7047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-02
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2560101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional