Provider Demographics
NPI:1033740881
Name:HENDRICKS, KATHARINE HOPE (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:HOPE
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KAYTEA
Other - Middle Name:
Other - Last Name:HENDRICKS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:117 MATEO CIR N
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4029
Mailing Address - Country:US
Mailing Address - Phone:719-760-2969
Mailing Address - Fax:
Practice Address - Street 1:5808 MCLEOD RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-2455
Practice Address - Country:US
Practice Address - Phone:505-821-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2023-0240101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional