Provider Demographics
NPI:1619372612
Name:BOOKHAMER, CATYA
Entity Type:Individual
Prefix:
First Name:CATYA
Middle Name:
Last Name:BOOKHAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATYA
Other - Middle Name:
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 LINCOLN WAY W
Mailing Address - Street 2:
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-1302
Mailing Address - Country:US
Mailing Address - Phone:717-485-3264
Mailing Address - Fax:
Practice Address - Street 1:119 LINCOLN WAY W
Practice Address - Street 2:
Practice Address - City:MC CONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233-1302
Practice Address - Country:US
Practice Address - Phone:717-485-3264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
PACW0210171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker