Provider Demographics
NPI:1356712442
Name:CARTER, KATHRYN HOPE (MS, LPC, LPCC, ATR-B)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:HOPE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS, LPC, LPCC, ATR-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 58036
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91413
Mailing Address - Country:US
Mailing Address - Phone:646-554-0990
Mailing Address - Fax:
Practice Address - Street 1:881 ALMA REAL DRIVE, SUITE 218
Practice Address - Street 2:RECONNECT INTEGRATIVE TRAUMA TREATMENT CENTER
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272
Practice Address - Country:US
Practice Address - Phone:310-909-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC821101YP2500X
VA0701003167101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional