Provider Demographics
NPI:1902578552
Name:CATHEY, CARLEEN N
Entity Type:Individual
Prefix:
First Name:CARLEEN
Middle Name:N
Last Name:CATHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 SOUTH CLARK ST.
Mailing Address - Street 2:STE. 700
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-4315
Mailing Address - Country:US
Mailing Address - Phone:240-736-7651
Mailing Address - Fax:
Practice Address - Street 1:2611 SOUTH CLARK ST.
Practice Address - Street 2:STE. 700
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202
Practice Address - Country:US
Practice Address - Phone:242-407-3676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant