Healthcare Provider Details

I. General information

NPI: 1346610334
Provider Name (Legal Business Name): CATHY WILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4951 CENTRAL AVE
MONROE LA
71203-6156
US

IV. Provider business mailing address

4951 CENTRAL AVE
MONROE LA
71203-6156
US

V. Phone/Fax

Practice location:
  • Phone: 318-340-1535
  • Fax: 318-340-1539
Mailing address:
  • Phone: 318-340-1535
  • Fax: 318-340-1539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17253
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17253
License Number StateLA
# 5
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: