Provider Demographics
NPI:1336675081
Name:DUNHAM, KATHERINE GORMAN
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GORMAN
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:EILEEN
Other - Last Name:GORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LPC, RPT
Mailing Address - Street 1:701 E 15TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-0708
Mailing Address - Country:US
Mailing Address - Phone:972-872-8487
Mailing Address - Fax:972-739-3535
Practice Address - Street 1:701 E 15TH ST STE 101
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-0708
Practice Address - Country:US
Practice Address - Phone:972-872-8487
Practice Address - Fax:972-739-3535
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75527101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75527OtherTEXAS LPC