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General NPI Number Information
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NPI Number | 1124250923
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Entity Type | Individual
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Provider Name | KATHERINE MANSFIELD HOULE PSY.D., M.S.W., B.S.
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Gender | Female
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 11055 LITTLE PATUXENT PKWY SUITE 201
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City | COLUMBIA
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State | MD
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Zip | 21044-2896
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Country | US
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Telephone | 202-680-4080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 664
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City | KENSINGTON
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State | MD
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Zip | 20895-0664
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Country | US
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Telephone | 301-300-0711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50078013
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT000085
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 13103
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License Number State | MD
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