Provider Demographics
NPI:1710341979
Name:CATALYST THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:CATALYST THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:ELOISE
Authorized Official - Last Name:VALDIZAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP/L
Authorized Official - Phone:623-363-1533
Mailing Address - Street 1:18213 N SKYHAWK DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-4402
Mailing Address - Country:US
Mailing Address - Phone:623-363-1533
Mailing Address - Fax:
Practice Address - Street 1:18213 N SKYHAWK DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-4402
Practice Address - Country:US
Practice Address - Phone:623-363-1533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-13
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSPLA 83982355S0801X
AZSLP6845235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1508291873Medicaid
AZ1750696126Medicaid