Provider Demographics
NPI:1356179691
Name:LAWLOR, CATHERINE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:LAWLOR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:497 TAHOE KEYS BLVD APT 35
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-3841
Mailing Address - Country:US
Mailing Address - Phone:574-261-5410
Mailing Address - Fax:
Practice Address - Street 1:497 TAHOE KEYS BLVD APT 35
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-3841
Practice Address - Country:US
Practice Address - Phone:574-261-5410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94028151103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical