MEDICARE: MISS KATHRYN M MCLAUGHLIN LMHC

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
1	101YM0800X	Mental Health Counselor	88001237A	IN
2	101YM0800X	Mental Health Counselor	39004444A	IN

General Provider Information

NPI Number	:	1487248738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KATHRYN M MCLAUGHLIN LMHC

Provider Business Mailing Address
First Line	:	2332 WHITE OAK AVE
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-2967
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	613 AIRPORT NORTH OFFICE PARK
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-6706
Country	:	US
Telephone Number	:	260-267-7676
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2021
Last Update Date	:	04/07/2023

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