Provider Demographics
NPI:1194385120
Name:MARDER, KATE (LPC, ATR-BC)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:MARDER
Suffix:
Gender:F
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77009-7723
Mailing Address - Country:US
Mailing Address - Phone:631-793-4898
Mailing Address - Fax:
Practice Address - Street 1:6550 FANNIN ST STE 2509
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2777
Practice Address - Country:US
Practice Address - Phone:346-238-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
221700000X
TX73384101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Multi-Specialty