Provider Demographics
NPI:1720477334
Name:MOUNT, KATHERINE BELLONE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:BELLONE
Last Name:MOUNT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:BELLONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-0624
Mailing Address - Fax:214-648-1208
Practice Address - Street 1:6363 FOREST PARK ROAD BL5.230
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9086
Practice Address - Country:US
Practice Address - Phone:214-648-0102
Practice Address - Fax:214-648-1208
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36990103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent