Provider Demographics
NPI:1154742344
Name:FLANAGAN, CATHY MARY (PHD)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:MARY
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 E 71ST ST
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4733
Mailing Address - Country:US
Mailing Address - Phone:212-472-4505
Mailing Address - Fax:
Practice Address - Street 1:331 E 71ST ST
Practice Address - Street 2:SUITE 1C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4733
Practice Address - Country:US
Practice Address - Phone:212-472-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-15
Last Update Date:2013-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11403103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical