Healthcare Provider Details

I. General information

NPI: 1497682819
Provider Name (Legal Business Name): BLU-HAZEL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

517 SALT POINT TPKE
POUGHKEEPSIE NY
12601-6526
US

IV. Provider business mailing address

517 SALT POINT TPKE
POUGHKEEPSIE NY
12601-6526
US

V. Phone/Fax

Practice location:
  • Phone: 845-444-1025
  • Fax:
Mailing address:
  • Phone: 845-444-1025
  • 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: DR. CATHERINE GLEASON
Title or Position: SOCIAL WORK
Credential: PHD, LCSW
Phone: 845-444-1025