MEDICARE: KATHERINE JEAN CLAPP BS, CAP, IC&RC ADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAP100200	FL

General Provider Information

NPI Number	:	1619503315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JEAN CLAPP BS, CAP, IC&RC ADC

Provider Business Mailing Address
First Line	:	13321 US HIGHWAY 1
Second Line	:
City	:	JUNO BEACH
State	:	FL
Zip	:	33408-2252
Country	:	US
Telephone Number	:	561-345-0927
Fax Number	:	844-833-5612

Provider Business Practice Location Address
First Line	:	13321 US HIGHWAY 1
Second Line	:
City	:	JUNO BEACH
State	:	FL
Zip	:	33408-2252
Country	:	US
Telephone Number	:	561-345-0927
Fax Number	:	844-833-5612

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

Provider Enumeration Date	:	03/14/2020
Last Update Date	:	03/14/2020

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