MEDICARE: MS. HELEN CATHERINE COGBURN MA, 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	101YP2500X	Professional Counselor	09375	TX

General Provider Information

NPI Number	:	1861688731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HELEN CATHERINE COGBURN MA, LPC

Provider Business Mailing Address
First Line	:	1406B RABB RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2023
Country	:	US
Telephone Number	:	512-236-8489
Fax Number	:

Provider Business Practice Location Address
First Line	:	1406B RABB RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78704-2023
Country	:	US
Telephone Number	:	512-236-8489
Fax Number	:

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

Provider Enumeration Date	:	09/24/2007
Last Update Date	:	10/01/2007

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