Provider Demographics
NPI:1760984595
Name:ISEMINGER, KAITLYN B (MA, LPC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:B
Last Name:ISEMINGER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25203 TUCKAHOE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8013
Mailing Address - Country:US
Mailing Address - Phone:832-205-8138
Mailing Address - Fax:832-384-9456
Practice Address - Street 1:25203 TUCKAHOE LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8013
Practice Address - Country:US
Practice Address - Phone:832-205-8138
Practice Address - Fax:832-384-9456
Is Sole Proprietor?:No
Enumeration Date:2018-03-07
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 390200000X
TX91617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program