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General NPI Number Information
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NPI Number | 1316763030
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Entity Type | Individual
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Provider Name | KATRINA LACOMBE MA, LPC, ATR
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Gender |
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 6478 SCANLAN AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-2402
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Country | US
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Telephone | 816-877-6590
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Fax |
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Provider Business Mailing Address
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Address Line | 6478 SCANLAN AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63139-2402
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Country | US
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Telephone | 816-877-6590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 22-215
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2020032634
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License Number State | MO
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