Provider Demographics
NPI:1396327425
Name:EADS, KATHERYN ANNE (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KATHERYN
Middle Name:ANNE
Last Name:EADS
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 DOVE HL
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3632
Mailing Address - Country:US
Mailing Address - Phone:305-890-6383
Mailing Address - Fax:
Practice Address - Street 1:217 DOVE HL
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-3632
Practice Address - Country:US
Practice Address - Phone:305-890-6383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health