MEDICARE: KATHRYN CECAVA MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1396258216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN CECAVA MS

Provider Business Mailing Address
First Line	:	3104 SHAWNEE TRL
Second Line	:
City	:	ALAMOGORDO
State	:	NM
Zip	:	88310-4019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 W GRIGGS AVE STE C
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2603
Country	:	US
Telephone Number	:	575-405-7146
Fax Number	:	575-405-5446

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2017
Last Update Date	:	05/22/2025

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