Provider Demographics
NPI:1487178281
Name:BEAVER, KATIE LOUISE (LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:KATIE
Middle Name:LOUISE
Last Name:BEAVER
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5455 RICHMOND AVE APT 1005
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6679
Mailing Address - Country:US
Mailing Address - Phone:936-522-8789
Mailing Address - Fax:
Practice Address - Street 1:3033 GESSNER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-1000
Practice Address - Country:US
Practice Address - Phone:713-329-7506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TX74728101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor