Provider Demographics
NPI:1407697790
Name:MCDEARMON, KATELYN ANNE (LGPC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ANNE
Last Name:MCDEARMON
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 IRISHTOWN DR
Mailing Address - Street 2:
Mailing Address - City:EMMITSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21727-9231
Mailing Address - Country:US
Mailing Address - Phone:757-251-8782
Mailing Address - Fax:
Practice Address - Street 1:27 IRISHTOWN DR
Practice Address - Street 2:
Practice Address - City:EMMITSBURG
Practice Address - State:MD
Practice Address - Zip Code:21727-9231
Practice Address - Country:US
Practice Address - Phone:757-251-8782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional