Provider Demographics
NPI:1396437620
Name:LAYMON, KATHARINE JEAN (MS, LPCC)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:JEAN
Last Name:LAYMON
Suffix:
Gender:F
Credentials:MS, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 COVENTRY LN
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-4403
Mailing Address - Country:US
Mailing Address - Phone:763-258-9936
Mailing Address - Fax:
Practice Address - Street 1:131 COVENTRY LN
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-4403
Practice Address - Country:US
Practice Address - Phone:763-258-9936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-24
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC02868101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional