Healthcare Provider Details

I. General information

NPI: 1881262061
Provider Name (Legal Business Name): KATHRYN HEWITT LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4397 FEDERAL DR
GREENSBORO NC
27410-8116
US

IV. Provider business mailing address

4397 FEDERAL DR
GREENSBORO NC
27410-8116
US

V. Phone/Fax

Practice location:
  • Phone: 336-462-9510
  • Fax: 336-579-3510
Mailing address:
  • Phone: 336-462-9510
  • Fax: 336-579-3510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15413
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: