Provider Demographics
NPI:1003439886
Name:NGUYEN, KAITLIN C (LPC)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:C
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KAITLIN
Other - Middle Name:G
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:14781 MEMORIAL DR # 232
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5210
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:955 DAIRY ASHFORD RD STE 108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5307
Practice Address - Country:US
Practice Address - Phone:281-407-4143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-27
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83212101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health