Healthcare Provider Details

I. General information

NPI: 1033037718
Provider Name (Legal Business Name): CATHERINE PRYA DHALIWAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIA DHALIWAL

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 LAMAR AVE STE 203
CHARLOTTE NC
28204-2436
US

IV. Provider business mailing address

322 LAMAR AVE STE 203
CHARLOTTE NC
28204-2436
US

V. Phone/Fax

Practice location:
  • Phone: 980-580-7272
  • Fax:
Mailing address:
  • Phone: 980-580-7272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: