Provider Demographics
NPI:1669811964
Name:MARUTZKY, CATHY DIAN (MED, LPCC, NCC)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:DIAN
Last Name:MARUTZKY
Suffix:
Gender:F
Credentials:MED, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 WATERVILLE CT
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-5383
Mailing Address - Country:US
Mailing Address - Phone:214-906-5513
Mailing Address - Fax:
Practice Address - Street 1:23030 LYONS AVE STE 205
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2755
Practice Address - Country:US
Practice Address - Phone:214-906-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA3956101YP2500X
NE4194101YM0800X
CA3956101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health