Provider Demographics
NPI:1891568192
Name:RESECK, KATELYN (LMHCA, LMFTA)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:RESECK
Suffix:
Gender:F
Credentials:LMHCA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 S ANDERSON ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-3104
Mailing Address - Country:US
Mailing Address - Phone:509-676-9171
Mailing Address - Fax:
Practice Address - Street 1:1177 JADWIN AVE STE 105
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3404
Practice Address - Country:US
Practice Address - Phone:509-676-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61484114101YM0800X
WAMG61484222106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health