MEDICARE: KATHLEEN MORTON, LPC

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	101YP2500X	Professional Counselor	72306	TX

General Provider Information

NPI Number	:	1154868826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATHLEEN MORTON, LPC

Provider Business Mailing Address
First Line	:	1412 HUCKLEBERRY LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-2212
Country	:	US
Telephone Number	:	703-944-2929
Fax Number	:

Provider Business Practice Location Address
First Line	:	1412 HUCKLEBERRY LN
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78748-2212
Country	:	US
Telephone Number	:	703-944-2929
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	MRS. KATHLEEN MORTON
Credential	:	LPC
Telephone Number	:	703-944-2929

Provider Enumeration Date	:	01/19/2017
Last Update Date	:	01/19/2017

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