MEDICARE: KATRINA TIE

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	100028	TX
2	101Y00000X	Counselor	2026003674	MO

General Provider Information

NPI Number	:	1437035250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATRINA TIE

Provider Business Mailing Address
First Line	:	12320 BARKER CYPRESS RD STE 600
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-8329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18103 CANYON CYPRESS LN
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-7588
Country	:	US
Telephone Number	:	281-944-5008
Fax Number	:

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

Provider Enumeration Date	:	08/15/2025
Last Update Date	:	02/17/2026

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Directions to “ KATRINA TIE ” Practice Location

Language	Start Address	Practice Location

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