MEDICARE: KATELYNN FRUM 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
1	101YP2500X	Professional Counselor	80148	TX

General Provider Information

NPI Number	:	1801479001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATELYNN FRUM LPC

Provider Business Mailing Address
First Line	:	11313 FATHOM ST
Second Line	:
City	:	AUBREY
State	:	TX
Zip	:	76227-3153
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2601 LITTLE ELM PKWY STE 302
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-1919
Country	:	US
Telephone Number	:	214-475-0345
Fax Number	:

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

Provider Enumeration Date	:	05/04/2021
Last Update Date	:	05/04/2021

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