Provider Demographics
NPI:1578119152
Name:SHELTON, KATHERINE V (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:V
Last Name:SHELTON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7981 168TH AVE NE STE 134
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-0911
Mailing Address - Country:US
Mailing Address - Phone:425-439-7755
Mailing Address - Fax:
Practice Address - Street 1:7981 168TH AVE NE STE 134
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-0911
Practice Address - Country:US
Practice Address - Phone:425-439-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-10
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61335046101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health