Healthcare Provider Details

I. General information

NPI: 1023794443
Provider Name (Legal Business Name): KATRINA ELISE FEYERHERM LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2023
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 S HUDSON AVE
TULSA OK
74114-6323
US

IV. Provider business mailing address

12409 LARGO DR APT 27
SAVANNAH GA
31419-2044
US

V. Phone/Fax

Practice location:
  • Phone: 404-721-1893
  • Fax:
Mailing address:
  • Phone: 401-524-9515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC015558
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: