Provider Demographics
NPI:1932613122
Name:COOLEY, CATHERINE LYNN (LCSW)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LYNN
Last Name:COOLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12605 WALROND RD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-6632
Mailing Address - Country:US
Mailing Address - Phone:317-213-7399
Mailing Address - Fax:
Practice Address - Street 1:970 LOGAN ST
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2252
Practice Address - Country:US
Practice Address - Phone:317-213-7399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007602A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical