Provider Demographics
NPI:1720420185
Name:MITCHELL, KATHERINE (LPC-INTERN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 SPRING ST # 234
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-4056
Mailing Address - Country:US
Mailing Address - Phone:713-380-1151
Mailing Address - Fax:
Practice Address - Street 1:2204 SUMMER ST # 113
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007
Practice Address - Country:US
Practice Address - Phone:713-380-1151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2018-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79277101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health