Provider Demographics
NPI:1326545237
Name:ALLEN, KATRINA DARCHELL (LPC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:DARCHELL
Last Name:ALLEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3430 MCKELVEY ROAD
Mailing Address - Street 2:STE L, PMB 1406
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-4325
Mailing Address - Country:US
Mailing Address - Phone:314-435-5241
Mailing Address - Fax:
Practice Address - Street 1:3430 MCKELVEY ROAD
Practice Address - Street 2:STE L, PMB 1406
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044
Practice Address - Country:US
Practice Address - Phone:314-435-5241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-07
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional