Provider Demographics
NPI:1629159215
Name:NORTHERN VALLEY CATHOLIC SOCIAL SERVICE, INC.
Entity Type:Organization
Organization Name:NORTHERN VALLEY CATHOLIC SOCIAL SERVICE, INC.
Other - Org Name:SHASTA COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:530-241-0552
Mailing Address - Street 1:2400 WASHINGTON AVE.
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2832
Mailing Address - Country:US
Mailing Address - Phone:530-241-0552
Mailing Address - Fax:530-247-3354
Practice Address - Street 1:2400 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2802
Practice Address - Country:US
Practice Address - Phone:530-241-0552
Practice Address - Fax:530-247-3347
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN VALLEY CATHOLIC SOCIAL SERVICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-18
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management