Provider Demographics
NPI:1952962243
Name:PACE, KATHRYN THOMPSON (LCMHC)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:THOMPSON
Last Name:PACE
Suffix:
Gender:
Credentials:LCMHC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:COBLE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 E KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27288-5201
Mailing Address - Country:US
Mailing Address - Phone:336-623-9711
Mailing Address - Fax:336-635-6864
Practice Address - Street 1:6845 NC HIGHWAY 135
Practice Address - Street 2:
Practice Address - City:MAYODAN
Practice Address - State:NC
Practice Address - Zip Code:27027-8126
Practice Address - Country:US
Practice Address - Phone:336-623-9711
Practice Address - Fax:336-635-6864
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13167101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional