Healthcare Provider Details

I. General information

NPI: 1083965289
Provider Name (Legal Business Name): CATHERINE CATTELL LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 WILSHIRE BLVD STE 204
SANTA MONICA CA
90401-1737
US

IV. Provider business mailing address

2118 WILSHIRE BLVD # 174
SANTA MONICA CA
90403-5704
US

V. Phone/Fax

Practice location:
  • Phone: 917-882-4324
  • Fax:
Mailing address:
  • Phone: 917-882-4324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR027759
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126978
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: