MEDICARE: KATRINA MAHER 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	101YM0800X	Mental Health Counselor	84175	TX

General Provider Information

NPI Number	:	1255196242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA MAHER LPC

Provider Business Mailing Address
First Line	:	5038 RASPUTIN CT
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78413-5134
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5038 RASPUTIN CT
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78413-5134
Country	:	US
Telephone Number	:	361-779-2986
Fax Number	:

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

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/19/2024

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