Provider Demographics
NPI:1104510023
Name:TUZHILIN, CATHERINE (CASAC-T)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:TUZHILIN
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:OWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13827-1798
Mailing Address - Country:US
Mailing Address - Phone:160-762-1882
Mailing Address - Fax:
Practice Address - Street 1:117 FRONT ST
Practice Address - Street 2:
Practice Address - City:OWEGO
Practice Address - State:NY
Practice Address - Zip Code:13827-1798
Practice Address - Country:US
Practice Address - Phone:160-762-1882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY36898101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor