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NPI Code Detail

MEDICARE: DR. KATIE TART ALLEN PSY.D.

MEDICARE:  DR. KATIE TART ALLEN  PSY.D.
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
1103T00000XPsychologistPSY003583GA
2103TC0700XClinical Psychologist4833NC

General Provider Information

NPI Number : 1215284906
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATIE TART ALLEN PSY.D.
Provider Business Mailing Address
First Line : 128 RALEIGH ST
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-9043
Country : US
Telephone Number : 404-480-0332
Fax Number : 919-551-7569
Provider Business Practice Location Address
First Line : 128 RALEIGH ST
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-9043
Country : US
Telephone Number : 404-480-0332
Fax Number : 919-551-7569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2012
Last Update Date : 03/03/2026

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