Healthcare Provider Details

I. General information

NPI: 1992155592
Provider Name (Legal Business Name): KATHERINE MAHAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12202 TIMBERCROSS CIR
RICHMOND VA
23233-2243
US

IV. Provider business mailing address

12202 TIMBERCROSS CIR
RICHMOND VA
23233-2243
US

V. Phone/Fax

Practice location:
  • Phone: 804-601-6190
  • Fax:
Mailing address:
  • Phone: 804-601-6190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number72594
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: