Provider Demographics
NPI:1851557979
Name:HOUSTON, KATHLEEN MATHENY (LPCC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MATHENY
Last Name:HOUSTON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7945 PORTAGE ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-7806
Mailing Address - Country:US
Mailing Address - Phone:330-966-0616
Mailing Address - Fax:
Practice Address - Street 1:7945 PORTAGE ST NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-7806
Practice Address - Country:US
Practice Address - Phone:330-966-0616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0003066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health