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NPI Code Detail

MEDICARE: KATIES WAY KILLEEN PLLC

MEDICARE: KATIES WAY KILLEEN PLLC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner
2364SF0001XFamily Health Clinical Nurse Specialist
3103TP0814XPsychoanalysis Psychologist
4101YP2500XProfessional Counselor
5103G00000XClinical Neuropsychologist
6103T00000XPsychologist
7103TB0200XCognitive & Behavioral Psychologist
8103TP0016XPrescribing (Medical) Psychologist
91041C0700XClinical Social Worker
10106H00000XMarriage & Family Therapist
11202D00000XIntegrative Medicine Physician
12207QA0505XAdult Medicine Physician
132084B0040XBehavioral Neurology & Neuropsychiatry Physician
142084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1T6078OTHERTXLICENSE

General Provider Information

NPI Number : 1205573425
Entity Type Code : Organization
Provider Name (Legal Business Name) : KATIES WAY KILLEEN PLLC
Provider Business Mailing Address
First Line : 2025 MEMORY LN STE 500
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-7489
Country : US
Telephone Number : 806-810-0585
Fax Number : 806-517-2667
Provider Business Practice Location Address
First Line : 2025 MEMORY LN STE 500
Second Line :
City : HARKER HEIGHTS
State : TX
Zip : 76548-7489
Country : US
Telephone Number : 806-810-0585
Fax Number : 806-517-2667
Authorized Official
Title or Position : DIRECTOR OF CREDENDIALING
Name : KELLY JOHNSON
Credential : DIRECTOR OF BILLING
Telephone Number : 785-320-6616
Provider Enumeration Date : 05/18/2022
Last Update Date : 11/21/2024

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