Individual
MS. KATHRYN MICHELE MACAULAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, LPC,NCC,CCMHC
Contact information
Practice address
OVERTON BROOKS VA MEDICAL CENTER 510 EAST STONER AVENUE, SHREVEPORT, LA 71101-4295
(318) 221-8411
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3290
LA
106H00000X
Marriage & Family Therapist
Primary
MFT1043
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YP2500X
NPI PROFESSIONAL COUNSELO
LA
01
—
106H00000X
MARRIAGE & FAMILY THERAPI
LA
Enumeration date
05/04/2007
Last updated
11/05/2024
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