Provider Demographics
NPI:1386798775
Name:CATHEY, CAROL LEE (MFT)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:LEE
Last Name:CATHEY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MRS
Other - First Name:CAROL
Other - Middle Name:LEE
Other - Last Name:ZENTMYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1528 VALLEY CREST ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108
Mailing Address - Country:US
Mailing Address - Phone:702-636-2019
Mailing Address - Fax:702-638-1540
Practice Address - Street 1:9402 W LAKE MEAD BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134
Practice Address - Country:US
Practice Address - Phone:702-233-6003
Practice Address - Fax:702-638-1540
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV738106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist