Provider Demographics
NPI:1376820811
Name:BIVENS, KATHI J (LPC)
Entity Type:Individual
Prefix:
First Name:KATHI
Middle Name:J
Last Name:BIVENS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 MASTERS VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ETOWAH
Mailing Address - State:NC
Mailing Address - Zip Code:28729-7769
Mailing Address - Country:US
Mailing Address - Phone:828-595-4300
Mailing Address - Fax:
Practice Address - Street 1:619 OAKLAND ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3645
Practice Address - Country:US
Practice Address - Phone:828-595-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10521101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional