Provider Demographics
NPI:1134246614
Name:AMOS, CATHERINE ELIZABETH (LMHC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ELIZABETH
Last Name:AMOS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11592
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98508-1592
Mailing Address - Country:US
Mailing Address - Phone:360-357-4579
Mailing Address - Fax:
Practice Address - Street 1:222 KENYON ST NW
Practice Address - Street 2:SUITE 7
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4553
Practice Address - Country:US
Practice Address - Phone:360-357-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health