Healthcare Provider Details

I. General information

NPI: 1538706809
Provider Name (Legal Business Name): KATHRYN C CLINE LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHRYN A COHAGAN LCPC

II. Dates (important events)

Enumeration Date: 12/05/2019
Last Update Date: 09/06/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10630 LITTLE PATUXENT PKWY STE 209
COLUMBIA MD
21044-6278
US

IV. Provider business mailing address

3634 HILMAR RD
BALTIMORE MD
21244-3122
US

V. Phone/Fax

Practice location:
  • Phone: 410-740-8066
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC9346
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: