Provider Demographics
NPI:1477687622
Name:DEEN, KATRINA P (MS, LPA)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:P
Last Name:DEEN
Suffix:
Gender:F
Credentials:MS, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 CHAPANOKE RD STE 101
Mailing Address - Street 2:319 CHAPANOKE RD. STE. 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-3433
Mailing Address - Country:US
Mailing Address - Phone:919-662-4600
Mailing Address - Fax:919-662-4473
Practice Address - Street 1:319 CHAPANOKE RD STE 101
Practice Address - Street 2:319 CHAPANOKE RD. STE. 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-3433
Practice Address - Country:US
Practice Address - Phone:919-662-4600
Practice Address - Fax:919-662-4473
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1765103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC046-NPOtherBLUE CROSS BLUE SHIELD