Provider Demographics
NPI:1942644364
Name:PORTER, KATIE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:
Last Name:PORTER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 STONEHOLLOW DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2494
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1420 STONEHOLLOW DR
Practice Address - Street 2:SUITE C
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2494
Practice Address - Country:US
Practice Address - Phone:281-454-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67920101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional