Provider Demographics
NPI:1972627370
Name:LOUISE, CATHERINE (LCSW)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:LOUISE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:LOUISE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1400 EMELINE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-1976
Mailing Address - Country:US
Mailing Address - Phone:831-454-4170
Mailing Address - Fax:831-454-4663
Practice Address - Street 1:95-5583 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:NAALEHU
Practice Address - State:HI
Practice Address - Zip Code:96772
Practice Address - Country:US
Practice Address - Phone:831-588-8382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-3824101YM0800X
CALCS215811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health