Individual ProviderKathy Mae EkrenMarriage & Family TherapistBehavioral Health & Social Service ProvidersPractice Address3558 Round Barn Blvd Ste 200, Santa Rosa, CA 95403-0991(707) 843-7887PECOS EnrollmentThis provider is enrolled in PECOS as KATHY EKREN.Based on the most recent information from CMS, provider Kathy Mae Ekren is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1043538499Provider TypeIndividualFull NameEkren, Kathy MaeCredentialLMFTGenderFemaleSole ProprietorYesEnumeration Date5/10/2010Last Updated11/24/2023Contact InformationPractice LocationPractice Address3558 Round Barn Blvd Ste 200, Santa Rosa, CA 95403-0991Phone(707) 843-7887FaxUnlisted FaxMailing LocationMailing Address3558 Round Barn Blvd Ste 200, Santa Rosa, CA 95403-0991Phone(707) 843-7887FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106H00000XPrimaryDescriptionMarriage & Family TherapistBehavioral Health & Social Service ProvidersLicense94889CaliforniaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense60444728WashingtonProvider IdentifiersIDDescriptionIssuerID3719942DescriptionMedicaidIssuerUnlistedCaliforniaID94889DescriptionOtherIssuerBOARD OF BEHAVIORAL SCIENCESCalifornia