Provider Demographics
NPI:1679237812
Name:DAVIS, KATHLEEN ANN (LPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5821 SOUTHWEST FWY STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7501
Mailing Address - Country:US
Mailing Address - Phone:713-910-0296
Mailing Address - Fax:713-910-0358
Practice Address - Street 1:5821 SOUTHWEST FWY STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7501
Practice Address - Country:US
Practice Address - Phone:713-910-0296
Practice Address - Fax:713-910-0358
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62380101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional