Provider Demographics
NPI:1548075856
Name:CATALPA PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:CATALPA PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIORAL HEALTH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-648-0726
Mailing Address - Street 1:7610 N EASTLAKE TER APT 1S
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-7191
Mailing Address - Country:US
Mailing Address - Phone:917-648-0726
Mailing Address - Fax:
Practice Address - Street 1:7610 N EASTLAKE TER APT 1S
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-7191
Practice Address - Country:US
Practice Address - Phone:917-648-0726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty