Provider Demographics
NPI:1417232737
Name:PRACHT, KATHLEEN C (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:C
Last Name:PRACHT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:BETHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:155 S COURT AVE UNIT 1408
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3210
Mailing Address - Country:US
Mailing Address - Phone:352-978-2988
Mailing Address - Fax:
Practice Address - Street 1:1015 SIKES BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33815-4499
Practice Address - Country:US
Practice Address - Phone:863-688-4981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12660101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health