Provider Demographics
NPI:1841343506
Name:ECHOLS, KATHY BENITEZ (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:KATHY
Middle Name:BENITEZ
Last Name:ECHOLS
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:MISS
Other - First Name:KATHY
Other - Middle Name:JJO
Other - Last Name:LAUGHLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:720 ENERGY CENTER BLVD
Mailing Address - Street 2:502
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5828
Mailing Address - Country:US
Mailing Address - Phone:205-344-5507
Mailing Address - Fax:205-344-5508
Practice Address - Street 1:720 ENERGY CENTER BLVD
Practice Address - Street 2:502
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5828
Practice Address - Country:US
Practice Address - Phone:205-344-5507
Practice Address - Fax:205-344-5508
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2088101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51530497Medicare UPIN