Provider Demographics
NPI:1558379875
Name:MCIVER, KATHERINE (LPC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MCIVER
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 1:4406 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3314
Mailing Address - Country:US
Mailing Address - Phone:512-323-2302
Mailing Address - Fax:512-323-2371
Practice Address - Street 1:4406 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3314
Practice Address - Country:US
Practice Address - Phone:512-323-2302
Practice Address - Fax:512-323-2371
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16602101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4180LCOtherBLUE CROSS BLUE SHIELD NO