Provider Demographics
NPI:1376282665
Name:GENTRY, CATHERINE A (LPC, LCDC, CCTP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:A
Last Name:GENTRY
Suffix:
Gender:F
Credentials:LPC, LCDC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 PINE VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4509
Mailing Address - Country:US
Mailing Address - Phone:832-748-7999
Mailing Address - Fax:832-536-5549
Practice Address - Street 1:25301 BOROUGH PARK DR STE 121
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3561
Practice Address - Country:US
Practice Address - Phone:713-364-4134
Practice Address - Fax:832-536-5549
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15813101YA0400X
TX87253101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)