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NPI Code Detail

MEDICARE: MRS. KATIE HENRY LPC, NCC

MEDICARE: MRS. KATIE HENRY LPC, NCC
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 Counselor75492TX

General Provider Information

NPI Number : 1891289690
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATIE HENRY LPC, NCC
Provider Business Mailing Address
First Line : 921 WOODVIEW DR
Second Line :
City : PROSPER
State : TX
Zip : 75078-9758
Country : US
Telephone Number : 214-923-9147
Fax Number :
Provider Business Practice Location Address
First Line : 161 W 3RD ST
Second Line :
City : PROSPER
State : TX
Zip : 75078-2906
Country : US
Telephone Number : 214-814-2873
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2018
Last Update Date : 06/15/2018

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