Provider Demographics
NPI:1245341163
Name:GEORGULAS, KATHERINE C (MA LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:C
Last Name:GEORGULAS
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:C
Other - Last Name:BRAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA LPC
Mailing Address - Street 1:4207 GARDENDALE ST
Mailing Address - Street 2:SUITE 101-B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3182
Mailing Address - Country:US
Mailing Address - Phone:210-615-1626
Mailing Address - Fax:210-615-1636
Practice Address - Street 1:9950 CYPRESSWOOD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3414
Practice Address - Country:US
Practice Address - Phone:281-807-4555
Practice Address - Fax:281-251-8846
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6548LCOtherBCBS OF TEXAS
TX566685OtherVALUE OPTIONS