Provider Demographics
NPI:1942378104
Name:KANE, CATHY COURTNEY (PHD)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:COURTNEY
Last Name:KANE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CURRIE HALL PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4312
Mailing Address - Country:US
Mailing Address - Phone:330-673-5812
Mailing Address - Fax:330-673-7162
Practice Address - Street 1:190 CURRIE HALL PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4312
Practice Address - Country:US
Practice Address - Phone:330-673-5812
Practice Address - Fax:330-673-7162
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4816103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH197387000OtherMAGELLAN
OH70981OtherQUAL CHOICE
OH1015118OtherCIGNA
000000345254OtherANTHEM
OH0971613Medicaid
OH1015118OtherCIGNA
KACP 15243Medicare ID - Type Unspecified