Provider Demographics
NPI:1679308944
Name:DELLA CATENA, LIZBETH VELAZQUEZ
Entity type:Individual
Prefix:
First Name:LIZBETH
Middle Name:VELAZQUEZ
Last Name:DELLA CATENA
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 1:1516 SEVEN PINES RD APT G
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62704-6615
Mailing Address - Country:US
Mailing Address - Phone:305-793-7664
Mailing Address - Fax:
Practice Address - Street 1:3001 SPRING MILL DR STE F
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62704-6599
Practice Address - Country:US
Practice Address - Phone:305-793-7664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling