Provider Demographics
NPI:1649767831
Name:CLEMENT, CATHY ANN (LPC)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:CLEMENT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 BLOSSOM CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-7169
Mailing Address - Country:US
Mailing Address - Phone:202-510-2415
Mailing Address - Fax:919-772-1978
Practice Address - Street 1:69 SHIPWASH DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-6860
Practice Address - Country:US
Practice Address - Phone:919-772-1990
Practice Address - Fax:919-772-1978
Is Sole Proprietor?:No
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA13877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health