Healthcare Provider Details

I. General information

NPI: 1003295437
Provider Name (Legal Business Name): K D CATHEY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 TOWNE CENTER PL #1300
RIDGELAND MS
39157-4869
US

IV. Provider business mailing address

1527 HAWTHORNE PL
CLINTON MS
39056-3910
US

V. Phone/Fax

Practice location:
  • Phone: 601-977-9353
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number1361
License Number StateMS

VIII. Authorized Official

Name: DR. KAREN D CATHEY
Title or Position: COUNSELOR
Credential: PH.D., M.DIV., LPC-S
Phone: 662-202-2160