MEDICARE: CATHY WOYAHN LCSW-R

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	1041C0700X	Clinical Social Worker	072609	NY

General Provider Information

NPI Number	:	1114141041
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHY WOYAHN LCSW-R

Provider Business Mailing Address
First Line	:	264 NORTH RD
Second Line	:
City	:	MILTON
State	:	NY
Zip	:	12547-5506
Country	:	US
Telephone Number	:	845-901-1067
Fax Number	:	845-728-0667

Provider Business Practice Location Address
First Line	:	658 AARON CT
Second Line	:
City	:	KINGSTON
State	:	NY
Zip	:	12401-2968
Country	:	US
Telephone Number	:	845-901-1076
Fax Number	:	845-728-0667

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

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	03/07/2017

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