Provider Demographics
NPI:1003687781
Name:KD COUNSELING LLC
Entity Type:Organization
Organization Name:KD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHEIRNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DALSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:601-595-1895
Mailing Address - Street 1:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:AL
Mailing Address - Zip Code:35121-0008
Mailing Address - Country:US
Mailing Address - Phone:601-595-1895
Mailing Address - Fax:
Practice Address - Street 1:128 N CHALKVILLE RD
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1373
Practice Address - Country:US
Practice Address - Phone:662-408-6965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty