Provider Demographics
NPI:1588833875
Name:CATALETA, JENNIFER MAY (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MAY
Last Name:CATALETA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 E MORTEN AVE APT 240
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-4616
Mailing Address - Country:US
Mailing Address - Phone:329-454-2299
Mailing Address - Fax:
Practice Address - Street 1:UNIT 26610
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09036
Practice Address - Country:DE
Practice Address - Phone:49931-889-7768
Practice Address - Fax:49931-889-7772
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC 10639101YA0400X
AZLCSW 27851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLISAC 10639OtherLISAC
AZLCSW2785OtherLCSW