Healthcare Provider Details

I. General information

NPI: 1841068061
Provider Name (Legal Business Name): ZAKIYA CATLIN LPC-IT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2023
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 FORWARD DRIVE
MADISON WI
53711-2443
US

IV. Provider business mailing address

815 FORWARD DRIVE
MADISON WI
53711-2443
US

V. Phone/Fax

Practice location:
  • Phone: 608-268-6530
  • Fax: 608-709-1744
Mailing address:
  • Phone: 608-268-6530
  • Fax: 608-709-1744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8450-226
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: