Provider Demographics
NPI:1114237856
Name:FLEMING, KATIE ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:ANN
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6040 CAMP BOWIE BLVD
Mailing Address - Street 2:SUITE 59
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-5612
Mailing Address - Country:US
Mailing Address - Phone:817-381-8166
Mailing Address - Fax:817-579-7376
Practice Address - Street 1:6040 CAMP BOWIE BLVD
Practice Address - Street 2:SUITE 59
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-5612
Practice Address - Country:US
Practice Address - Phone:817-381-8166
Practice Address - Fax:817-579-7176
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63918171W00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171W00000XOther Service ProvidersContractor