Provider Demographics
NPI:1437634995
Name:ROBERTS, KATHLEEN DUPREE (LMHC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:DUPREE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N MULLAN RD STE 214
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-3793
Mailing Address - Country:US
Mailing Address - Phone:720-273-6805
Mailing Address - Fax:
Practice Address - Street 1:200 N MULLAN RD STE 214
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-3793
Practice Address - Country:US
Practice Address - Phone:720-273-6805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60719574101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health