1316954407 NPI number — MONA CATTAN L.C.S.W.

Table of content: MONA CATTAN L.C.S.W. (NPI 1316954407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316954407 NPI number — MONA CATTAN L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CATTAN
Provider First Name:
MONA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CATTAN-LEWIS
Provider Other First Name:
MONA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1316954407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9111 WILSON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40242-3452
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-451-6662
Provider Business Mailing Address Fax Number:
502-451-6665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9111 WILSON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40242-3452
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-451-6662
Provider Business Practice Location Address Fax Number:
502-451-6662
Provider Enumeration Date:
08/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  KY-1355 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 1355 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000201858 . This is a "ANTHEM BC BS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 239269 . This is a "COMPSYCH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 453126 . This is a "VALUE OPTIONS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 8200025800 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000539139 . This is a "ANTHEM" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 10654346504 . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1078665 . This is a "CIGNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 820000258 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000201848 . This is a "ANTHEM INTERWOVEN WELLNES" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 11496482 . This is a "CAQH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 268317000 . This is a "MAGELLAN BEH HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 7065283 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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