Provider Demographics
NPI:1366242653
Name:KATHERINE BRACKEN, PHD, PLLC
Entity type:Organization
Organization Name:KATHERINE BRACKEN, PHD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACKEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-667-6783
Mailing Address - Street 1:8951 HARVEST OAKS DR STE 201
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2114
Mailing Address - Country:US
Mailing Address - Phone:984-266-2839
Mailing Address - Fax:984-220-9477
Practice Address - Street 1:8951 HARVEST OAKS DR STE 201
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2114
Practice Address - Country:US
Practice Address - Phone:984-266-2839
Practice Address - Fax:984-220-9477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-15
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty