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NPI Code Detail

MEDICARE: KATHRYN W. MCMILLAN MA., LPC, LMFT

MEDICARE: KATHRYN W. MCMILLAN MA., LPC, LMFT
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
1101Y00000XCounselor2289LA
2106H00000XMarriage & Family Therapist111LA

General Provider Information

NPI Number : 1306905609
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN W. MCMILLAN MA., LPC, LMFT
Provider Business Mailing Address
First Line : 105 WESTMARK BLVD STE C
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-7371
Country : US
Telephone Number : 337-654-9037
Fax Number : 337-269-5525
Provider Business Practice Location Address
First Line : 105 WESTMARK BLVD STE C
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-7371
Country : US
Telephone Number : 337-654-9037
Fax Number : 337-269-5525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 08/24/2022

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