Provider Demographics
NPI:1962479675
Name:CATRON, JEREMY PAUL (LCSW)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:PAUL
Last Name:CATRON
Suffix:
Gender:M
Credentials:LCSW
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 1205
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42261-1205
Mailing Address - Country:US
Mailing Address - Phone:270-526-2228
Mailing Address - Fax:270-526-2218
Practice Address - Street 1:1111 LOVERS LN
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42103-7169
Practice Address - Country:US
Practice Address - Phone:270-745-9945
Practice Address - Fax:270-526-2218
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical