Provider Demographics
NPI:1902679574
Name:CLEVELAND, KATRINA (MS, LPC)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 WOLFETON WAY
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2023
Mailing Address - Country:US
Mailing Address - Phone:972-467-9342
Mailing Address - Fax:
Practice Address - Street 1:1996 SCHERTZ PKWY STE 501
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1681
Practice Address - Country:US
Practice Address - Phone:512-557-4491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX85471101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional