Provider Demographics
NPI:1316159098
Name:WELLWOOD, CATHERINE ANN (LPC, CDC II, MAC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:WELLWOOD
Suffix:
Gender:F
Credentials:LPC, CDC II, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 HOSPITAL DR STE 109
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7809
Mailing Address - Country:US
Mailing Address - Phone:907-364-4472
Mailing Address - Fax:907-364-4484
Practice Address - Street 1:3245 HOSPITAL DR STE 109
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801-7809
Practice Address - Country:US
Practice Address - Phone:907-364-4472
Practice Address - Fax:907-364-4484
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3072101YA0400X
AK271101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional