=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326103268
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CATHY L. CLOVER M.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2006
-----------------------------------------------------
Last Update Date | 06/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2722 WILMINGTON RD
-----------------------------------------------------
City | NEW CASTLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16105-1241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-658-9398
-----------------------------------------------------
Fax | 724-656-1429
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2722 WILMINGTON RD
-----------------------------------------------------
City | NEW CASTLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16105-1241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-658-9398
-----------------------------------------------------
Fax | 724-656-1429
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TF0200X
-----------------------------------------------------
Taxonomy Name | Forensic Psychologist
-----------------------------------------------------
License Number | PS-005964-L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TP2701X
-----------------------------------------------------
Taxonomy Name | Group Psychotherapy Psychologist
-----------------------------------------------------
License Number | PS-005964-L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | PS-005964-L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------