Healthcare Provider Details

I. General information

NPI: 1396759908
Provider Name (Legal Business Name): KATHERINE ORLOFF DURHAM LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7517 STATE HIGHWAY 75 S
HUNTSVILLE TX
77340-2485
US

IV. Provider business mailing address

356 ELKINS LK
HUNTSVILLE TX
77340-7308
US

V. Phone/Fax

Practice location:
  • Phone: 936-291-3391
  • Fax:
Mailing address:
  • Phone: 936-295-6222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number29112
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: