Provider Demographics
NPI:1205592201
Name:MAHAN, KATRINA (LPC)
Entity type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:MAHAN
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 1:2125 HEIGHTS DR STE 1B
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6146
Mailing Address - Country:US
Mailing Address - Phone:715-506-5150
Mailing Address - Fax:
Practice Address - Street 1:2125 HEIGHTS DR STE 1B
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6146
Practice Address - Country:US
Practice Address - Phone:715-506-5150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-14
Last Update Date:2025-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health