MEDICARE: MRS. KATHERINE BROUSSARD BARNER 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	19533	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	258804	OTHER		COMPSYCH
2	7111LC	OTHER	TX	BLUE CROSS BLUE SHIELD
3	273935	OTHER		COMPSYCH
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265548663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHERINE BROUSSARD BARNER LPC

Provider Business Mailing Address
First Line	:	2811 WHITINHAM DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77067-1131
Country	:	US
Telephone Number	:	832-489-1811
Fax Number	:	713-688-4184

Provider Business Practice Location Address
First Line	:	5200 MITCHELLDALE ST
Second Line	:	SUITE E-11
City	:	HOUSTON
State	:	TX
Zip	:	77092-7206
Country	:	US
Telephone Number	:	832-489-1811
Fax Number	:	713-688-4184

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	03/05/2009

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