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NPI Code Detail

MEDICARE: KATHERINE GRANBERRY LPC

MEDICARE:   KATHERINE  GRANBERRY  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor61554TX

General Provider Information

NPI Number : 1477870624
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE GRANBERRY LPC
Provider Business Mailing Address
First Line : PO BOX 92041
Second Line :
City : AUSTIN
State : TX
Zip : 78709-2041
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 385 CREEK RD
Second Line :
City : DRIPPING SPRINGS
State : TX
Zip : 78620-3439
Country : US
Telephone Number : 512-797-4860
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2010
Last Update Date : 10/21/2021

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Directions to “ KATHERINE GRANBERRY LPC” Practice Location

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