Provider Demographics
NPI:1154991396
Name:PROFIT, CATHERINE LOUISE (MSS, LSW, YACEP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LOUISE
Last Name:PROFIT
Suffix:
Gender:F
Credentials:MSS, LSW, YACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2826
Mailing Address - Country:US
Mailing Address - Phone:609-955-0365
Mailing Address - Fax:
Practice Address - Street 1:245C NASSAU ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-4619
Practice Address - Country:US
Practice Address - Phone:609-375-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL066157001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical