Provider Demographics
NPI:1528330610
Name:CAGE, CHARLOTTE ANN (MFT)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:ANN
Last Name:CAGE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50147
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89513-0147
Mailing Address - Country:US
Mailing Address - Phone:775-338-3232
Mailing Address - Fax:775-322-3413
Practice Address - Street 1:63 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5577
Practice Address - Country:US
Practice Address - Phone:775-338-3232
Practice Address - Fax:775-322-3413
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0848106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist