Provider Demographics
NPI:1811337561
Name:RICHARD, CATHERINE ('CATHY') PAIGE (JD, MS, LCPC)
Entity type:Individual
Prefix:
First Name:CATHERINE ('CATHY')
Middle Name:PAIGE
Last Name:RICHARD
Suffix:
Gender:F
Credentials:JD, MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 W DICKERSON ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6851
Mailing Address - Country:US
Mailing Address - Phone:406-577-6712
Mailing Address - Fax:
Practice Address - Street 1:1940 W DICKERSON ST STE 102
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6851
Practice Address - Country:US
Practice Address - Phone:406-577-6712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCPC-LIC-4588101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health