Provider Demographics
NPI:1891216677
Name:CATHERINE M LAWDER LCSW PLLC
Entity Type:Organization
Organization Name:CATHERINE M LAWDER LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL / PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAWDER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:434-282-4998
Mailing Address - Street 1:914 E HIGH ST.
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4850
Mailing Address - Country:US
Mailing Address - Phone:434-282-4998
Mailing Address - Fax:434-989-0410
Practice Address - Street 1:421 PARK STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4749
Practice Address - Country:US
Practice Address - Phone:434-282-4998
Practice Address - Fax:434-989-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-30
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040023871041C0700X
VA0940023871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1013907302Medicaid