Provider Demographics
NPI:1205640703
Name:PETERSON, KATALA (LMFT-I)
Entity type:Individual
Prefix:
First Name:KATALA
Middle Name:
Last Name:PETERSON
Suffix:
Gender:F
Credentials:LMFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 N PARKER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-1213
Mailing Address - Country:US
Mailing Address - Phone:952-486-2719
Mailing Address - Fax:
Practice Address - Street 1:307 N MAIN ST STE 9
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4902
Practice Address - Country:US
Practice Address - Phone:919-201-7122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor