MEDICARE: CATHERINE OWEN CUOMO LCMHCS

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
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1053646562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE OWEN CUOMO LCMHCS

Provider Business Mailing Address
First Line	:	201 RAPHAEL DR
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27511-7906
Country	:	US
Telephone Number	:	303-241-3278
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 HIGHWOODS BLVD
Second Line	:	STE 310
City	:	RALEIGH
State	:	NC
Zip	:	27604-1027
Country	:	US
Telephone Number	:	919-714-7500
Fax Number	:

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

Provider Enumeration Date	:	10/16/2009
Last Update Date	:	10/16/2025

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