Healthcare Provider Details

I. General information

NPI: 1609163633
Provider Name (Legal Business Name): CATHRINE TROY MA, LPCC, LPAT ATR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 06/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11811 MENAUL BLVD NE
ALBUQUERQUE NM
87112-1788
US

IV. Provider business mailing address

11811 MENAUL BLVD NE
ALBUQUERQUE NM
87112-1788
US

V. Phone/Fax

Practice location:
  • Phone: 505-323-6002
  • Fax:
Mailing address:
  • Phone: 505-323-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1321
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: