Provider Demographics
NPI:1538679014
Name:SAUCIER, KATHLEEN HALBACH (MS, LPC, LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:HALBACH
Last Name:SAUCIER
Suffix:
Gender:F
Credentials:MS, LPC, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5737 CRAGFORD RD
Mailing Address - Street 2:
Mailing Address - City:LINEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36266-6705
Mailing Address - Country:US
Mailing Address - Phone:239-839-8543
Mailing Address - Fax:
Practice Address - Street 1:5737 CRAGFORD RD
Practice Address - Street 2:
Practice Address - City:LINEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36266-6705
Practice Address - Country:US
Practice Address - Phone:239-839-8543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9299101YM0800X
CT001751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health