Provider Demographics
NPI:1972789485
Name:PRELLWITZ, CATHY A (LCSW, PIP)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:A
Last Name:PRELLWITZ
Suffix:
Gender:F
Credentials:LCSW, PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 LORNA RD
Mailing Address - Street 2:STE 204
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5451
Mailing Address - Country:US
Mailing Address - Phone:205-413-1819
Mailing Address - Fax:205-905-7032
Practice Address - Street 1:3100 LORNA RD
Practice Address - Street 2:STE 204
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-5451
Practice Address - Country:US
Practice Address - Phone:205-413-1819
Practice Address - Fax:205-905-7032
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1943C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1943COtherSOCIAL WORK LICENSE