MEDICARE: MRS. KATHRYN ANN POE M.A., 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
1	101YM0800X	Mental Health Counselor	67628	TX
2	101YP2500X	Professional Counselor	67628	TX

General Provider Information

NPI Number	:	1669819504
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHRYN ANN POE M.A., LPC

Provider Business Mailing Address
First Line	:	551 GOLDEN GROVE PKWY
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-4578
Country	:	US
Telephone Number	:	432-260-6379
Fax Number	:

Provider Business Practice Location Address
First Line	:	3661 W WALNUT HILL LN
Second Line	:	APARTMENT 2148
City	:	IRVING
State	:	TX
Zip	:	75038-4044
Country	:	US
Telephone Number	:	432-260-6379
Fax Number	:

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

Provider Enumeration Date	:	06/02/2013
Last Update Date	:	09/23/2021

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