MEDICARE: KATHRYN GRAVES HUNSUCKER MA,LPC,LCAS,ACS,CCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	758	NC
2	101YP2500X	Professional Counselor	3827	NC
3	101Y00000X	Counselor	MHL-016-034	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003938820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN GRAVES HUNSUCKER MA,LPC,LCAS,ACS,CCS

Provider Business Mailing Address
First Line	:	3820 BRIDGES ST STE B
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2979
Country	:	US
Telephone Number	:	252-648-3124
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 BRIDGES ST STE B
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-2979
Country	:	US
Telephone Number	:	252-648-3124
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	06/28/2013

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