Provider Demographics
NPI:1417373671
Name:DEFRANK, KATIE LYNNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:LYNNE
Last Name:DEFRANK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:LYNNE
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12 OKLAHOMA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045
Mailing Address - Country:US
Mailing Address - Phone:973-543-5656
Mailing Address - Fax:973-543-1361
Practice Address - Street 1:12 OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:MONTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07045
Practice Address - Country:US
Practice Address - Phone:973-543-5656
Practice Address - Fax:973-543-1361
Is Sole Proprietor?:No
Enumeration Date:2014-03-12
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)