Provider Demographics
NPI:1699830299
Name:GAYRON, CATHERINE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANN
Last Name:GAYRON
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 1:400 MCCHESNEY AVE. EXT
Mailing Address - Street 2:APT 20-3
Mailing Address - City:TROY
Mailing Address - State:NY
Mailing Address - Zip Code:12180-8706
Mailing Address - Country:US
Mailing Address - Phone:518-279-4942
Mailing Address - Fax:
Practice Address - Street 1:267 HOOSICK STREET
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2467
Practice Address - Country:US
Practice Address - Phone:518-273-3209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR036650-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000410810001OtherBSNENY BEHAVIORAL HEALTH
NY4148328OtherMVP BEHAVIORAL HEALTH
NY4148328OtherMVP BEHAVIORAL HEALTH