MEDICARE: MS. CATHY M MARES LCSW

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	CSW.09925278	CO
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1124329867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHY M MARES LCSW

Provider Business Mailing Address
First Line	:	2842 MATADOR RED AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1772
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2842 MATADOR RED AVE
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89086-1772
Country	:	US
Telephone Number	:	719-400-9461
Fax Number	:

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

Provider Enumeration Date	:	11/11/2010
Last Update Date	:	11/04/2025

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