Wakefield, Kathleen

Wakefield, Kathleen is an individual health care provider with primary practice located at 2323 W Front St , Tyler TX 75702-7704. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wakefield, Kathleen can be contacted via phone (903) 597-1351.

Contact Information

Primary practice address
2323 W Front St Tyler TX 75702-7704
Phone: (903) 597-1351
Fax: (903) 535-7384
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 22205 Texas
Behavioral Health & Social Service Providers / Clinical 1041C0700X 22205 Texas

Profile Details

NPI number 1063481380
LBN Legal business name Wakefield, Kathleen
Credentials LMSW-ACP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2006
Last updated Jan 4th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063481380 NPPES
Texas MEDICAID 169604901

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