Provider Demographics
NPI:1528573565
Name:CALLETTO, CATHERINE MARY (LPC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:MARY
Last Name:CALLETTO
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 1:1805 AIRLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-3912
Mailing Address - Country:US
Mailing Address - Phone:757-337-3501
Mailing Address - Fax:757-399-3316
Practice Address - Street 1:1805 AIRLINE BLVD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23707-3912
Practice Address - Country:US
Practice Address - Phone:757-337-3501
Practice Address - Fax:757-399-3316
Is Sole Proprietor?:No
Enumeration Date:2017-12-13
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007410101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional