Provider Demographics
NPI:1023889706
Name:CATHIEPWELLNESS
Entity type:Organization
Organization Name:CATHIEPWELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JADA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PANNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:703-216-1700
Mailing Address - Street 1:12897 SUNRISE RIDGE ALY
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-6290
Mailing Address - Country:US
Mailing Address - Phone:412-694-6627
Mailing Address - Fax:
Practice Address - Street 1:440 MONTICELLO AVE STE 1802
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-2670
Practice Address - Country:US
Practice Address - Phone:703-216-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health