Provider Demographics
NPI:1215511209
Name:DESCHAINE, CATHY R (LPC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:R
Last Name:DESCHAINE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10042 PRIMA RUN PL
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-5318
Mailing Address - Country:US
Mailing Address - Phone:719-243-2860
Mailing Address - Fax:
Practice Address - Street 1:3205 N ACADEMY BLVD STE 130
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5152
Practice Address - Country:US
Practice Address - Phone:719-344-7112
Practice Address - Fax:719-344-7821
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO379101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO922458646OtherCOLORADO DRIVERS LICENSE
CO379OtherDORA