Provider Demographics
NPI:1609039411
Name:DELOACH, CATHERINE (MA LPC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:DELOACH
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:DELOACH
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LPC
Mailing Address - Street 1:2715 LILY MILL RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210
Mailing Address - Country:US
Mailing Address - Phone:704-554-1678
Mailing Address - Fax:
Practice Address - Street 1:1125 E MOREHEAD ST
Practice Address - Street 2:SUITE 209
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204
Practice Address - Country:US
Practice Address - Phone:704-370-0334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3782101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional