MEDICARE: DR. CATHRYN CALVERT PSYD

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	103TC0700X	Clinical Psychologist	3432	CO

General Provider Information

NPI Number	:	1548570856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHRYN CALVERT PSYD

Provider Business Mailing Address
First Line	:	3225 TEMPLETON GAP RD
Second Line	:	SUITE 214
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8728
Country	:	US
Telephone Number	:	719-337-2237
Fax Number	:	855-646-6864

Provider Business Practice Location Address
First Line	:	3225 TEMPLETON GAP RD
Second Line	:	SUITE 214
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8728
Country	:	US
Telephone Number	:	719-337-2237
Fax Number	:	855-646-6864

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

Provider Enumeration Date	:	10/20/2010
Last Update Date	:	11/11/2014

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