Provider Demographics
NPI:1427550359
Name:MEDLIN, KATHY LYNN (LMFTA)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:LYNN
Last Name:MEDLIN
Suffix:
Gender:
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4113 GROVE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-3760
Mailing Address - Country:US
Mailing Address - Phone:919-830-0521
Mailing Address - Fax:
Practice Address - Street 1:355 S MADISON BLVD STE C1
Practice Address - Street 2:
Practice Address - City:ROXBORO
Practice Address - State:NC
Practice Address - Zip Code:27573-5485
Practice Address - Country:US
Practice Address - Phone:833-800-1505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20377A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist