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NPI Code Detail

MEDICARE: KALI BETH MCDONALD DEEGAN LMFT-SUPERVISOR, LPC

MEDICARE: KALI BETH MCDONALD DEEGAN LMFT-SUPERVISOR, 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
1101YP2500XProfessional Counselor77480TX
2106H00000XMarriage & Family Therapist202669TX

General Provider Information

NPI Number : 1508343138
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALI BETH MCDONALD DEEGAN LMFT-SUPERVISOR, LPC
Provider Business Mailing Address
First Line : 1785 STATE HIGHWAY 26 STE 200
Second Line :
City : GRAPEVINE
State : TX
Zip : 76051-2245
Country : US
Telephone Number : 817-221-8203
Fax Number :
Provider Business Practice Location Address
First Line : 1785 STATE HIGHWAY 26 STE 200
Second Line :
City : GRAPEVINE
State : TX
Zip : 76051-2245
Country : US
Telephone Number : 817-221-8203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2018
Last Update Date : 03/06/2026

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