Healthcare Provider Details

I. General information

NPI: 1619251063
Provider Name (Legal Business Name): KATHRYN MCGREGOR LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 37TH AVE S
MOORHEAD MN
56560-5524
US

IV. Provider business mailing address

3239 OAK RIDGE LOOP E STE 3
WEST FARGO ND
58078-8482
US

V. Phone/Fax

Practice location:
  • Phone: 701-451-4811
  • Fax: 651-925-0057
Mailing address:
  • Phone: 701-566-0783
  • Fax: 701-707-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2018-061
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2418
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: