Provider Demographics
NPI:1275391989
Name:KING, KATIE GUADALUPE (LPC-A)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:GUADALUPE
Last Name:KING
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S HIGHWAY 35 BYP APT 1315
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-4654
Mailing Address - Country:US
Mailing Address - Phone:832-390-0616
Mailing Address - Fax:
Practice Address - Street 1:2549 ROY RD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-8604
Practice Address - Country:US
Practice Address - Phone:281-485-9280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90699101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor