Provider Demographics
NPI:1720699325
Name:SANGI, CATHERINE
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:SANGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 S IRVING AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505-2049
Mailing Address - Country:US
Mailing Address - Phone:201-320-7385
Mailing Address - Fax:
Practice Address - Street 1:102 N ABINGTON RD STE 107
Practice Address - Street 2:
Practice Address - City:CLARKS GREEN
Practice Address - State:PA
Practice Address - Zip Code:18411-2300
Practice Address - Country:US
Practice Address - Phone:570-430-8204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC012516101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty