Provider Demographics
NPI:1043359953
Name:THERRELL, KATHERINE BROWN (LPC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:BROWN
Last Name:THERRELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 EAGLES ROOST LANE
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-7571
Mailing Address - Country:US
Mailing Address - Phone:828-687-0583
Mailing Address - Fax:828-687-0583
Practice Address - Street 1:3653 SWEETEN CREEK RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-2769
Practice Address - Country:US
Practice Address - Phone:828-651-0111
Practice Address - Fax:828-687-0583
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4544101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103698Medicaid