Provider Demographics
NPI:1629631064
Name:TARLETON, KATHERINE M (MFT, LMFT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:TARLETON
Suffix:
Gender:F
Credentials:MFT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 KINGSCREEK DR
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29650-5111
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:430 WOODRUFF RD STE 450
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3443
Practice Address - Country:US
Practice Address - Phone:864-400-5130
Practice Address - Fax:864-818-4697
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8127106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist