Provider Demographics
NPI:1285909812
Name:WOODING, CATHERINE RACHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:RACHELLE
Last Name:WOODING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:RACHELLE
Other - Last Name:BALLEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:205 PRONGHORN LOOP
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-4311
Mailing Address - Country:US
Mailing Address - Phone:817-707-8657
Mailing Address - Fax:
Practice Address - Street 1:205 PRONGHORN LOOP
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-4311
Practice Address - Country:US
Practice Address - Phone:817-707-8657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX421431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical