Provider Demographics
NPI:1679819759
Name:WHITE, KATHERINE D (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:D
Last Name:WHITE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 PINE SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:SHEPHERD
Mailing Address - State:TX
Mailing Address - Zip Code:77371-2513
Mailing Address - Country:US
Mailing Address - Phone:936-329-3475
Mailing Address - Fax:
Practice Address - Street 1:203 E CALHOUN ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-2965
Practice Address - Country:US
Practice Address - Phone:936-329-3475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18690101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional