MEDICARE: KATELYN CAHILLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CTB-2025-0223	NM

General Provider Information

NPI Number	:	1033905021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYN CAHILLY

Provider Business Mailing Address
First Line	:	9516 GOLDEN ROD CIR SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87116-3203
Country	:	US
Telephone Number	:	973-664-7612
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 MOUNTAIN RD NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87104-1359
Country	:	US
Telephone Number	:	505-557-4656
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2025
Last Update Date	:	04/16/2025

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Directions to “ KATELYN CAHILLY ” Practice Location

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