Provider Demographics
NPI:1467664110
Name:SURFACE, KATHERINE M (LPCC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:M
Last Name:SURFACE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MRS
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:HAUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:485 SPRING GROVE DR
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-1341
Mailing Address - Country:US
Mailing Address - Phone:330-603-2126
Mailing Address - Fax:
Practice Address - Street 1:485 SPRING GROVE DR
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1341
Practice Address - Country:US
Practice Address - Phone:330-603-2126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0001998101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional