Provider Demographics
NPI:1457722068
Name:REUTING, KATINA CAPRICE (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:KATINA
Middle Name:CAPRICE
Last Name:REUTING
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:KATINA
Other - Middle Name:CAPRICE
Other - Last Name:PETTIFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:202 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-2522
Mailing Address - Country:US
Mailing Address - Phone:984-269-8731
Mailing Address - Fax:336-438-2377
Practice Address - Street 1:202 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-2522
Practice Address - Country:US
Practice Address - Phone:984-269-8731
Practice Address - Fax:336-438-2377
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-08
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11853101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional