Provider Demographics
NPI:1851580245
Name:TYLER, CATHARINE L
Entity Type:Individual
Prefix:
First Name:CATHARINE
Middle Name:L
Last Name:TYLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-1267
Mailing Address - Country:US
Mailing Address - Phone:518-821-8997
Mailing Address - Fax:
Practice Address - Street 1:160 FAIRVIEW AVE STE 99
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-8404
Practice Address - Country:US
Practice Address - Phone:518-245-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-22
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0863381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical