Provider Demographics
NPI:1831483890
Name:GNEITING, CATHERINE ANN (PHD,LPC,LCAS-P)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:GNEITING
Suffix:
Gender:F
Credentials:PHD,LPC,LCAS-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NEW BRIDGE ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28540-4736
Mailing Address - Country:US
Mailing Address - Phone:910-934-7042
Mailing Address - Fax:
Practice Address - Street 1:201 NEW BRIDGE STREET
Practice Address - Street 2:SUITE 208
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-4736
Practice Address - Country:US
Practice Address - Phone:910-934-7042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8757101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104881Medicaid