Provider Demographics
NPI:1548989031
Name:AMMERMAN, KATHARINE (MS, LCHMC-A)
Entity type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:AMMERMAN
Suffix:
Gender:F
Credentials:MS, LCHMC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 QUADRANGLE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7890
Mailing Address - Country:US
Mailing Address - Phone:919-205-8305
Mailing Address - Fax:
Practice Address - Street 1:6320 QUADRANGLE DR STE 100
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7890
Practice Address - Country:US
Practice Address - Phone:919-205-8305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17971101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health