Provider Demographics
NPI:1619199825
Name:ENSANA, CATHERINE A (MA)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:ENSANA
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 1:34 SAINT DAVIDS PL
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08088-1126
Mailing Address - Country:US
Mailing Address - Phone:609-234-7964
Mailing Address - Fax:609-859-3855
Practice Address - Street 1:34 SAINT DAVIDS PL
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08088-1126
Practice Address - Country:US
Practice Address - Phone:609-234-7964
Practice Address - Fax:609-859-3855
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00064000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health