Provider Demographics
NPI:1962735837
Name:THOMAS-KEMP, CATHERINE (BS, LADAC, CCS)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:THOMAS-KEMP
Suffix:
Gender:F
Credentials:BS, LADAC, CCS
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 15008
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5008
Mailing Address - Country:US
Mailing Address - Phone:505-327-7218
Mailing Address - Fax:505-327-0828
Practice Address - Street 1:1313 MISSION AVE.
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401
Practice Address - Country:US
Practice Address - Phone:505-327-7218
Practice Address - Fax:505-327-0828
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3455101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)