Provider Demographics
NPI:1942427950
Name:CATHCART, CRYSTAL MAYA
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:MAYA
Last Name:CATHCART
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 1:1600 LAWRENCE ST APT 2
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4599
Mailing Address - Country:US
Mailing Address - Phone:805-844-0822
Mailing Address - Fax:
Practice Address - Street 1:SHELTERCARE, 1790 W 11TH, SUITE 290
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402
Practice Address - Country:US
Practice Address - Phone:541-686-1262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health