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NPI Code Detail

MEDICARE: KATHRYN G. LACKNER LPCC

MEDICARE: KATHRYN G. LACKNER LPCC
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 CounselorCCMH2128NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710968193
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN G. LACKNER LPCC
Provider Business Mailing Address
First Line : PO BOX 3141
Second Line :
City : CARLSBAD
State : NM
Zip : 88221-3141
Country : US
Telephone Number : 575-725-5552
Fax Number : 575-725-5552
Provider Business Practice Location Address
First Line : 1900 WESTRIDGE RD
Second Line :
City : CARLSBAD
State : NM
Zip : 88220-3550
Country : US
Telephone Number : 575-725-5552
Fax Number : 575-725-5552
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2005
Last Update Date : 10/16/2025

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Directions to “ KATHRYN G. LACKNER LPCC” Practice Location

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