Provider Demographics
NPI:1699504472
Name:DURANTE BERGUE ALVES, CATARINA (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:CATARINA
Middle Name:
Last Name:DURANTE BERGUE ALVES
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13110 ROCKAWAY ST
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-5230
Mailing Address - Country:US
Mailing Address - Phone:618-534-4423
Mailing Address - Fax:
Practice Address - Street 1:10 MAXWELL DR STE 205
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-2933
Practice Address - Country:US
Practice Address - Phone:518-288-7156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026454103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist