Healthcare Provider Details

I. General information

NPI: 1023200359
Provider Name (Legal Business Name): CATHERINE ANNE LARAYA CUASAY LMHC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2007
Last Update Date: 08/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 SAN PEDRO AVE 2ND FLOOR
SAN ANTONIO TX
78212-4610
US

IV. Provider business mailing address

702 SAN PEDRO AVE 2ND FLOOR
SAN ANTONIO TX
78212-4610
US

V. Phone/Fax

Practice location:
  • Phone: 210-299-2400
  • Fax: 210-226-0108
Mailing address:
  • Phone: 210-299-2400
  • Fax: 210-226-0108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4706
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17175
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: