Provider Demographics
NPI:1245748896
Name:TOMPKINS, KATHERINE H (LCMHCA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:H
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:
Other - Last Name:TOMPKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCMHCA
Mailing Address - Street 1:6120 SAINT GILES ST STE 240
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7046
Mailing Address - Country:US
Mailing Address - Phone:984-409-7949
Mailing Address - Fax:
Practice Address - Street 1:6120 SAINT GILES ST STE 240
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7046
Practice Address - Country:US
Practice Address - Phone:984-409-7949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017034856101YP2500X
NCA18040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional