Provider Demographics
NPI:1629399159
Name:CATHCART, LINDA (MA)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CATHCART
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 1:12170 E CORNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CORNVILLE
Mailing Address - State:AZ
Mailing Address - Zip Code:86325-5260
Mailing Address - Country:US
Mailing Address - Phone:928-301-4596
Mailing Address - Fax:
Practice Address - Street 1:12170 E CORNVILLE RD
Practice Address - Street 2:
Practice Address - City:CORNVILLE
Practice Address - State:AZ
Practice Address - Zip Code:86325-5260
Practice Address - Country:US
Practice Address - Phone:928-301-4596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-18
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1963676101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor