Provider Demographics
NPI:1699914200
Name:CAPP, CATHY TAYLOR (MSW, CSW-PIP)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:TAYLOR
Last Name:CAPP
Suffix:
Gender:F
Credentials:MSW, CSW-PIP
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:TAYLOR
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 404
Mailing Address - Street 2:
Mailing Address - City:BELLE FOURCHE
Mailing Address - State:SD
Mailing Address - Zip Code:57717-0404
Mailing Address - Country:US
Mailing Address - Phone:605-210-3115
Mailing Address - Fax:
Practice Address - Street 1:615 5TH AVE
Practice Address - Street 2:
Practice Address - City:BELLE FOURCHE
Practice Address - State:SD
Practice Address - Zip Code:57717-1405
Practice Address - Country:US
Practice Address - Phone:605-210-3115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD31001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical