MEDICARE: KATHERINE ANNE HENNINGS

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	101YP2500X	Professional Counselor	LC2135	MD

General Provider Information

NPI Number	:	1336412709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE ANNE HENNINGS

Provider Business Mailing Address
First Line	:	116 GRANVILLE DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-3012
Country	:	US
Telephone Number	:	301-661-3579
Fax Number	:

Provider Business Practice Location Address
First Line	:	116 GRANVILLE DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-3012
Country	:	US
Telephone Number	:	301-661-3579
Fax Number	:

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

Provider Enumeration Date	:	02/16/2012
Last Update Date	:	04/26/2016

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