Provider Demographics
NPI:1265548663
Name:BARNER, KATHERINE BROUSSARD (LPC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:BROUSSARD
Last Name:BARNER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2811 WHITINHAM DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-1131
Mailing Address - Country:US
Mailing Address - Phone:832-489-1811
Mailing Address - Fax:713-688-4184
Practice Address - Street 1:5200 MITCHELLDALE ST
Practice Address - Street 2:SUITE E-11
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7206
Practice Address - Country:US
Practice Address - Phone:832-489-1811
Practice Address - Fax:713-688-4184
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19533101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
258804OtherCOMPSYCH
TX7111LCOtherBLUE CROSS BLUE SHIELD
273935OtherCOMPSYCH
TX175059801Medicaid