MEDICARE: KATHERINE MAHAN 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	101YM0800X	Mental Health Counselor	72594	TX

General Provider Information

NPI Number	:	1992155592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE MAHAN LPC

Provider Business Mailing Address
First Line	:	12202 TIMBERCROSS CIR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-2243
Country	:	US
Telephone Number	:	804-601-6190
Fax Number	:

Provider Business Practice Location Address
First Line	:	3540 PUMP RD # 1209
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23233-1115
Country	:	US
Telephone Number	:	804-601-6190
Fax Number	:

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

Provider Enumeration Date	:	06/15/2016
Last Update Date	:	12/12/2025

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