Provider Demographics
NPI:1558630590
Name:DEAL, KATIE ANN (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:KATIE
Middle Name:ANN
Last Name:DEAL
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 1:1126 COOPER DR
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-2150
Mailing Address - Country:US
Mailing Address - Phone:515-570-0396
Mailing Address - Fax:
Practice Address - Street 1:1126 COOPER DR
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-2150
Practice Address - Country:US
Practice Address - Phone:515-570-0396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health