Provider Demographics
NPI:1326724907
Name:LEVINTHAL, KATHERINE GULLEDGE (MED, LCMHC-A)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GULLEDGE
Last Name:LEVINTHAL
Suffix:
Gender:F
Credentials:MED, LCMHC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1412 HILLBROW LN
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2861
Mailing Address - Country:US
Mailing Address - Phone:919-272-0386
Mailing Address - Fax:
Practice Address - Street 1:1412 HILLBROW LN
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-2861
Practice Address - Country:US
Practice Address - Phone:919-272-0386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA18891101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health