Provider Demographics
NPI:1730608779
Name:BARTON, KATIE (LPC, CRC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:BARTON
Suffix:
Gender:F
Credentials:LPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10811 COUNTY ROAD 152 W
Mailing Address - Street 2:
Mailing Address - City:BULLARD
Mailing Address - State:TX
Mailing Address - Zip Code:75757-8562
Mailing Address - Country:US
Mailing Address - Phone:936-554-2952
Mailing Address - Fax:
Practice Address - Street 1:10811 COUNTY ROAD 152 W
Practice Address - Street 2:
Practice Address - City:BULLARD
Practice Address - State:TX
Practice Address - Zip Code:75757-8562
Practice Address - Country:US
Practice Address - Phone:936-554-2952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-11
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81668101YM0800X, 101YP2500X
101YP2500X
AR171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator