Provider Demographics
NPI:1811060072
Name:FREDELLA, CATHERINE (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:FREDELLA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3226
Mailing Address - Country:US
Mailing Address - Phone:607-759-6468
Mailing Address - Fax:607-798-0861
Practice Address - Street 1:46 RIVERSIDE DR OFC 7
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-4511
Practice Address - Country:US
Practice Address - Phone:607-759-6468
Practice Address - Fax:607-798-0861
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047780-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical