Provider Demographics
NPI:1548553308
Name:HAUN, CATHERINE ANNE (LMSW)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:ANNE
Last Name:HAUN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 VALENCIA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1750
Mailing Address - Country:US
Mailing Address - Phone:505-256-0834
Mailing Address - Fax:
Practice Address - Street 1:1218 GRIEGOS RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87107-3752
Practice Address - Country:US
Practice Address - Phone:505-345-8471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-07661104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker