Healthcare Provider Details

I. General information

NPI: 1356072110
Provider Name (Legal Business Name): KATRINA HEMBREE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15015 W BELL RD STE 101
SURPRISE AZ
85374-3248
US

IV. Provider business mailing address

16430 N SCOTTSDALE RD STE 210
SCOTTSDALE AZ
85254-1581
US

V. Phone/Fax

Practice location:
  • Phone: 623-269-4870
  • Fax: 623-269-4871
Mailing address:
  • Phone: 602-464-9576
  • Fax: 480-428-0475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-21080
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: