Provider Demographics
NPI:1548412166
Name:STOCK, CATHERINE ELIZABETH (MA)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:STOCK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 LINDELL RD
Mailing Address - Street 2:#101
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-1253
Mailing Address - Country:US
Mailing Address - Phone:702-367-0393
Mailing Address - Fax:702-367-1067
Practice Address - Street 1:3611 LINDELL RD
Practice Address - Street 2:#101
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-1253
Practice Address - Country:US
Practice Address - Phone:702-367-0393
Practice Address - Fax:702-367-1067
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVR07065106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist