Provider Demographics
NPI:1962450718
Name:POTTKOTTER, KATHLEEN B (PHD, LPC, RPT-S)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:B
Last Name:POTTKOTTER
Suffix:
Gender:F
Credentials:PHD, LPC, RPT-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 WEST LOOP S
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2421
Mailing Address - Country:US
Mailing Address - Phone:713-828-7744
Mailing Address - Fax:
Practice Address - Street 1:5959 WEST LOOP S
Practice Address - Street 2:SUITE 410
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2421
Practice Address - Country:US
Practice Address - Phone:713-828-7744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14660101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional