Provider Demographics
NPI:1316068323
Name:HARMATUK, KATHLEEN M (LPC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:HARMATUK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4803 SAN FELIPE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3907
Mailing Address - Country:US
Mailing Address - Phone:630-653-1717
Mailing Address - Fax:713-627-7715
Practice Address - Street 1:6823 CYPRESSWOOD DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7705
Practice Address - Country:US
Practice Address - Phone:281-376-8006
Practice Address - Fax:281-376-8008
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006317101YP2500X
TX63633101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional