Provider Demographics
NPI:1609197953
Name:BOZARTH, CATHY ANN (LPC)
Entity type:Individual
Prefix:
First Name:CATHY
Middle Name:ANN
Last Name:BOZARTH
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:CATHY
Other - Middle Name:ANN
Other - Last Name:CALDERON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1215 SW G ST
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-2544
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 BEATTY ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97501-5811
Practice Address - Country:US
Practice Address - Phone:541-476-2373
Practice Address - Fax:541-479-3514
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0013939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional