Provider Demographics
NPI:1629499942
Name:CATHY, ROLETHA LASHELL (LCSW)
Entity Type:Individual
Prefix:
First Name:ROLETHA
Middle Name:LASHELL
Last Name:CATHY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 BRICK ROW DR
Mailing Address - Street 2:APT 4205
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4947
Mailing Address - Country:US
Mailing Address - Phone:214-477-3833
Mailing Address - Fax:
Practice Address - Street 1:18601 LBJ FWY
Practice Address - Street 2:160
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5600
Practice Address - Country:US
Practice Address - Phone:214-477-3833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-05
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical