Healthcare Provider Details

I. General information

NPI: 1700186103
Provider Name (Legal Business Name): KATHERINE THERRELL, LPC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2010
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 EAGLES ROOST LN
FLETCHER NC
28732-7571
US

IV. Provider business mailing address

10 EAGLES ROOST LN
FLETCHER NC
28732-7571
US

V. Phone/Fax

Practice location:
  • Phone: 828-651-0111
  • Fax: 828-687-0583
Mailing address:
  • Phone: 828-651-0111
  • Fax: 828-687-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4544
License Number StateNC

VIII. Authorized Official

Name: MRS. KATHERINE BROWN THERRELL
Title or Position: COUNSELOR
Credential: MS LPC NCC
Phone: 828-687-0583