Provider Demographics
NPI:1891194254
Name:ROBERT A. CATANESE
Entity Type:Organization
Organization Name:ROBERT A. CATANESE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:CATANESE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:423-339-3996
Mailing Address - Street 1:2775 EXECUTIVE PARK NW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37312-2763
Mailing Address - Country:US
Mailing Address - Phone:423-339-3996
Mailing Address - Fax:423-479-9682
Practice Address - Street 1:2775 EXECUTIVE PARK NW
Practice Address - Street 2:SUITE 1
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312-2763
Practice Address - Country:US
Practice Address - Phone:423-339-3996
Practice Address - Fax:423-479-9682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001361103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3681820Medicaid
TN4316118OtherBLUE CROSS BLUE SHIELD TN
TN3681820Medicaid