Provider Demographics
NPI:1154499614
Name:BURRELSMAN, KATHERINE MARIE (MFT)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:MARIE
Last Name:BURRELSMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 ARDMORE DR
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-1762
Mailing Address - Country:US
Mailing Address - Phone:805-683-6341
Mailing Address - Fax:
Practice Address - Street 1:107 E MICHELTORENA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1905
Practice Address - Country:US
Practice Address - Phone:805-965-6786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAMFC41573106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist