Basic Information
| Provider Information | |||||||||
| NPI: | 1275181430 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MIEREK | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | LCMHC/LCAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 255 DOGWOOD RD | ||||||||
| Address2: | |||||||||
| City: | CANDLER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287158448 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1340 PATTON AVE STE D | ||||||||
| Address2: | |||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288062623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282634195 | ||||||||
| FaxNumber: | 8285441201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2019 | ||||||||
| LastUpdateDate: | 08/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | LCAS-25846 | NC | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | 15301 | NC | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.