Provider Demographics
NPI:1184983082
Name:FOYTIK, CATHERINE (LISW-S, ACHT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:FOYTIK
Suffix:
Gender:F
Credentials:LISW-S, ACHT
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:E
Other - Last Name:FOYTIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW-S, ACHT
Mailing Address - Street 1:6269 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3036
Mailing Address - Country:US
Mailing Address - Phone:440-558-2475
Mailing Address - Fax:440-558-2665
Practice Address - Street 1:6269 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3036
Practice Address - Country:US
Practice Address - Phone:440-558-2475
Practice Address - Fax:440-558-2665
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI11016881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0078131Medicaid
OHH161770OtherINDIVIDUAL MEDICARE PTAN
OH0169910Medicaid