MEDICARE: CRAIG KERN M.A. LPC-S, LMFT

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	63559	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1821273442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG KERN M.A. LPC-S, LMFT

Provider Business Mailing Address
First Line	:	8913 COLLINFIELD DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-6704
Country	:	US
Telephone Number	:	512-324-6878
Fax Number	:

Provider Business Practice Location Address
First Line	:	8913 COLLINFIELD DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78758-6704
Country	:	US
Telephone Number	:	512-324-6878
Fax Number	:

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	08/17/2011

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