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General NPI Number Information
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NPI Number | 1861790768
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Entity Type | Individual
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Provider Name | KATRINA COLLETON LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 915 CLOPPER RD APT A3
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1237
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Country | US
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Telephone | 240-543-3748
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Fax | 240-715-9673
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Provider Business Mailing Address
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Address Line | 915 CLOPPER RD APT A3
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City | GAITHERSBURG
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State | MD
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Zip | 20878-1237
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Country | US
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Telephone |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LC2826
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM363
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License Number State | MD
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