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NPI Code Detail

MEDICARE: KATIE LYNN MAGRUDER LCPC

MEDICARE: KATIE LYNN MAGRUDER LCPC
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
1101YM0800XMental Health CounselorLGP11914MD
2101YM0800XMental Health CounselorLC14174MD

General Provider Information

NPI Number : 1336811330
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE LYNN MAGRUDER LCPC
Provider Business Mailing Address
First Line : 200 GLENN ST STE 302
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-2583
Country : US
Telephone Number : 240-580-1919
Fax Number :
Provider Business Practice Location Address
First Line : 200 GLENN ST STE 302
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-2583
Country : US
Telephone Number : 240-580-1919
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2021
Last Update Date : 09/06/2023

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