Provider Demographics
NPI:1912141185
Name:NEATHERY, KATHRYN RENEE (LMFT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:RENEE
Last Name:NEATHERY
Suffix:
Gender:
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 NATCHITOCHES ST
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71292-3751
Mailing Address - Country:US
Mailing Address - Phone:318-855-8773
Mailing Address - Fax:
Practice Address - Street 1:1416 NATCHITOCHES ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71292-3751
Practice Address - Country:US
Practice Address - Phone:318-855-8773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist