Provider Demographics
NPI:1811628142
Name:SMITH, KATHERINE (LPC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KAT
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:820 W DANFORTH RD # 1133
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-5006
Mailing Address - Country:US
Mailing Address - Phone:405-825-1564
Mailing Address - Fax:
Practice Address - Street 1:820 W DANFORTH RD # 1133
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5006
Practice Address - Country:US
Practice Address - Phone:405-825-1564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-17
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10834101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor