Provider Demographics
NPI:1679992267
Name:DEREGNIER, KATHERINE SUE (LPCC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SUE
Last Name:DEREGNIER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:SUE
Other - Last Name:BUHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:10535 165TH ST W
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-5729
Mailing Address - Country:US
Mailing Address - Phone:952-435-0022
Mailing Address - Fax:952-435-0095
Practice Address - Street 1:10535 165TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-5729
Practice Address - Country:US
Practice Address - Phone:952-435-0022
Practice Address - Fax:952-435-0095
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01479101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional