Provider Demographics
NPI:1134505365
Name:KELTON, CATHRINE SUSANNE (LPC)
Entity Type:Individual
Prefix:
First Name:CATHRINE
Middle Name:SUSANNE
Last Name:KELTON
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 1:1115 LYNNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-6659
Mailing Address - Country:US
Mailing Address - Phone:432-894-3141
Mailing Address - Fax:817-242-5128
Practice Address - Street 1:190 N RIDGEWAY DR STE 105
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4020
Practice Address - Country:US
Practice Address - Phone:432-894-3141
Practice Address - Fax:817-242-5128
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70487101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health