Provider Demographics
NPI:1740163849
Name:KEA, KATIE NICOLE (LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:NICOLE
Last Name:KEA
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 1:275 RUSSELL RD
Mailing Address - Street 2:
Mailing Address - City:LIPAN
Mailing Address - State:TX
Mailing Address - Zip Code:76462-3735
Mailing Address - Country:US
Mailing Address - Phone:817-372-1371
Mailing Address - Fax:
Practice Address - Street 1:1301 SE 14TH AVE
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8544
Practice Address - Country:US
Practice Address - Phone:940-325-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool