MEDICARE: CATALYST COUNSELING PSYCHOLOGY PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106H00000X	Marriage & Family Therapist
2	103T00000X	Psychologist
3	1041C0700X	Clinical Social Worker
4	103TC1900X	Counseling Psychologist
5	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1609676436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATALYST COUNSELING PSYCHOLOGY PLLC

Provider Business Mailing Address
First Line	:	100 PARK AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017-5516
Country	:	US
Telephone Number	:	646-596-6169
Fax Number	:	646-494-0140

Provider Business Practice Location Address
First Line	:	100 PARK AVENUE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10017
Country	:	US
Telephone Number	:	646-481-0914
Fax Number	:	646-481-0902

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTINE FERNANDEZ
Credential	:	PHD
Telephone Number	:	646-481-0914

Provider Enumeration Date	:	03/19/2025
Last Update Date	:	03/02/2026

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