Provider Demographics
NPI:1477903268
Name:KATE, CAROLYN JENNIFER (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:JENNIFER
Last Name:KATE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 MERIDA DR
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:NM
Mailing Address - Zip Code:88021-8225
Mailing Address - Country:US
Mailing Address - Phone:575-805-4234
Mailing Address - Fax:575-882-1095
Practice Address - Street 1:254 MERIDA DR
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:NM
Practice Address - Zip Code:88021-8225
Practice Address - Country:US
Practice Address - Phone:575-805-4234
Practice Address - Fax:575-882-1095
Is Sole Proprietor?:No
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMT-0181091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health