Provider Demographics
NPI:1326486341
Name:WEIR, KATE GOOD (LPC, RPT)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:GOOD
Last Name:WEIR
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 SAMANTHA CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0271
Mailing Address - Country:US
Mailing Address - Phone:573-356-9009
Mailing Address - Fax:
Practice Address - Street 1:701 W HIGH ST
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65101-1525
Practice Address - Country:US
Practice Address - Phone:573-636-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011039650101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional