Provider Demographics
NPI:1891398194
Name:TEMPLE, CATHERINE ROSE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ROSE
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:CATE
Other - Middle Name:
Other - Last Name:TEMPLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW,LCSW
Mailing Address - Street 1:273 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-2853
Mailing Address - Country:US
Mailing Address - Phone:570-415-1982
Mailing Address - Fax:
Practice Address - Street 1:273 E 7TH ST
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-2853
Practice Address - Country:US
Practice Address - Phone:570-415-1982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0209781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty