Provider Demographics
NPI:1720769797
Name:CAT CONFIDENTIAL AUTHENTIC THERAPY LLC
Entity Type:Organization
Organization Name:CAT CONFIDENTIAL AUTHENTIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOLM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:920-791-3042
Mailing Address - Street 1:3 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54615-1408
Mailing Address - Country:US
Mailing Address - Phone:920-791-3042
Mailing Address - Fax:
Practice Address - Street 1:3 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-1408
Practice Address - Country:US
Practice Address - Phone:920-791-3042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty