Provider Demographics
NPI:1588617468
Name:REINBOLD, CATHY KILLIAN (LPC, LEAP, LCAS)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:KILLIAN
Last Name:REINBOLD
Suffix:
Gender:F
Credentials:LPC, LEAP, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 WEST MOREHEAD STREET, SUITE 114
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208
Mailing Address - Country:US
Mailing Address - Phone:704-374-1071
Mailing Address - Fax:704-374-1078
Practice Address - Street 1:1230 W MOREHEAD ST
Practice Address - Street 2:SUITE 114
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5205
Practice Address - Country:US
Practice Address - Phone:704-374-1071
Practice Address - Fax:704-374-1078
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35101Y00000X
NC555101YA0400X
NC2425101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional