Healthcare Provider Details

I. General information

NPI: 1053084152
Provider Name (Legal Business Name): CATALPA COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 SIERRA DR SE STE 10
ALBUQUERQUE NM
87108-5633
US

IV. Provider business mailing address

231 SIERRA DR SE STE 10
ALBUQUERQUE NM
87108-5633
US

V. Phone/Fax

Practice location:
  • Phone: 207-899-7515
  • Fax:
Mailing address:
  • Phone: 207-899-7515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES DION HAMEL
Title or Position: THERAPIST
Credential: LCSW
Phone: 207-899-7515