Provider Demographics
NPI:1215068788
Name:CIALLELLA, CATHERINE LOUISE (MS LMHC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:LOUISE
Last Name:CIALLELLA
Suffix:
Gender:F
Credentials:MS LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:99121-0001
Mailing Address - Country:US
Mailing Address - Phone:509-779-4936
Mailing Address - Fax:509-779-4936
Practice Address - Street 1:296 UPPER DANVILLE ROAD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:WA
Practice Address - Zip Code:99121-0001
Practice Address - Country:US
Practice Address - Phone:509-779-4936
Practice Address - Fax:509-779-4936
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004042101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional