Provider Demographics
NPI:1265163380
Name:EBY, KATHRYN ANN (LPC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:EBY
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 1:1406 W ROCKSPRAY RD
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1720
Mailing Address - Country:US
Mailing Address - Phone:267-614-1621
Mailing Address - Fax:
Practice Address - Street 1:1406 W ROCKSPRAY RD
Practice Address - Street 2:
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1720
Practice Address - Country:US
Practice Address - Phone:267-614-1621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-20
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001553101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health