NPI 1407926645 · live from the CMS NPI Registry
Kathy A Benedetto, MA LPE LPC LMFT
Marriage & Family Therapist in Johnson City, TN. National Provider Identifier 1407926645, active.
NPI record
| NPI | 1407926645 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 109 W Watauga Ave, Watauga Behavioral Health, Johnson City, TN 37601 |
| Practice phone | 423-232-2700 |
| Mailing address | 1167 Spratlin Park Drive, Gray, TN 37615 |
| Enumerated | November 8, 2006 |
| Last updated | October 14, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | LPC598 (TN) |
| Counselor, Professional | 101YP2500X | 598 (TN) |
| Psychologist | 103T00000X | LPE434 (TN) |
| Marriage & Family Therapist primary | 106H00000X | LMFT219 (TN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.