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General NPI Number Information
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NPI Number | 1487269312
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Entity Type | Individual
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Provider Name | KAITLYN FUSARI LMHC, LPC
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Gender | Female
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 9555 LEBANON RD
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City | FRISCO
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State | TX
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Zip | 75035-6095
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Country | US
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Telephone | 214-502-3521
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Fax |
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Provider Business Mailing Address
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Address Line | 7101 VIRGINIA PKWY APT 532
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City | MCKINNEY
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State | TX
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Zip | 75071-5757
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Country | US
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Telephone | 631-624-1024
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 010655
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License Number State | NY
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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 | 87207
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License Number State | TX
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