Basic Information
| Provider Information | |||||||||
| NPI: | 1669704169 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ASHBY | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | CORUM | ||||||||
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| Credential: | LPCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1733 SAN YSIDRO CROSSING | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875075768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392488757 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1733 SAN YSIDRO XING | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875073369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302739541 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2010 | ||||||||
| LastUpdateDate: | 10/25/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | T-0129061 | NM | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.