Provider Demographics
NPI:1194488528
Name:SPRINKLE, KATHERINE EVANS (LCMHCA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:EVANS
Last Name:SPRINKLE
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 GREENBROOK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-4326
Mailing Address - Country:US
Mailing Address - Phone:336-279-0586
Mailing Address - Fax:
Practice Address - Street 1:3300 BATTLEGROUND AVE STE 303
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-2491
Practice Address - Country:US
Practice Address - Phone:336-663-6570
Practice Address - Fax:336-907-3461
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16728101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health