Provider Demographics
NPI:1982151346
Name:KLAEHN, KATRINA D'ANN (MA, LPC, LSOTP)
Entity Type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:D'ANN
Last Name:KLAEHN
Suffix:
Gender:F
Credentials:MA, LPC, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 RIDGECREST CIR STE B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-5498
Mailing Address - Country:US
Mailing Address - Phone:806-803-5013
Mailing Address - Fax:806-553-1312
Practice Address - Street 1:4231 RIDGECREST CIR STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-5498
Practice Address - Country:US
Practice Address - Phone:806-803-5013
Practice Address - Fax:806-553-1312
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74076101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3025488-03Medicaid