Provider Demographics
NPI:1235290933
Name:SMITH, KATHERINE L (LCMFT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCMFT
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:L
Other - Last Name:KISTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:305 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-2005
Mailing Address - Country:US
Mailing Address - Phone:913-712-0318
Mailing Address - Fax:
Practice Address - Street 1:305 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2005
Practice Address - Country:US
Practice Address - Phone:913-712-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS725106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist