Provider Demographics
NPI:1679791388
Name:COULSON, CATHERINE (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:COULSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 YORK RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5600
Mailing Address - Country:US
Mailing Address - Phone:410-823-5577
Mailing Address - Fax:
Practice Address - Street 1:1615 YORK RD
Practice Address - Street 2:SUITE 302
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5600
Practice Address - Country:US
Practice Address - Phone:410-823-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08346101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD54490601OtherBLUE CROSS BLUE SHIELD