Provider Demographics
NPI:1487300869
Name:CATHERINE A DAESCH
Entity type:Organization
Organization Name:CATHERINE A DAESCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:DAESCH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:618-235-3857
Mailing Address - Street 1:28 BRONZE POINTE N STE B
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-1191
Mailing Address - Country:US
Mailing Address - Phone:618-235-3857
Mailing Address - Fax:618-235-3843
Practice Address - Street 1:28 BRONZE POINTE N STE B
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1191
Practice Address - Country:US
Practice Address - Phone:618-235-3857
Practice Address - Fax:618-235-3843
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty