Healthcare Provider Details

I. General information

NPI: 1871719971
Provider Name (Legal Business Name): FAITH CATLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W PARK ST SUITE 312
LEBANON NH
03766-1378
US

IV. Provider business mailing address

4 MARKET ST. P.O. BOX 183
LYME NH
03768
US

V. Phone/Fax

Practice location:
  • Phone: 603-448-1611
  • Fax:
Mailing address:
  • Phone: 603-795-4103
  • Fax: 603-795-4193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number554
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: