Provider Demographics
NPI:1669610754
Name:NEWHOUSE, KATHERINE MAYFIELD (MFT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MAYFIELD
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:KATHERINE
Other - Middle Name:MAYFIELD
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:PO BOX 222576
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99522-2576
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1317 W NORTHERN LIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2399
Practice Address - Country:US
Practice Address - Phone:831-236-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK242106H00000X
CA46144106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist