DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: KATHRYN COSTELLO LPC

MEDICARE: KATHRYN COSTELLO LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor5571LA
2101YP2500XProfessional Counselor5571LA

General Provider Information

NPI Number : 1992225650
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN COSTELLO LPC
Provider Business Mailing Address
First Line : 3800 FERNRIDGE DR
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-2516
Country : US
Telephone Number : 318-805-2132
Fax Number :
Provider Business Practice Location Address
First Line : 3821 SOUTHERN AVE
Second Line :
City : SHREVEPORT
State : LA
Zip : 71106-1033
Country : US
Telephone Number : 318-946-8157
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2017
Last Update Date : 09/24/2025

Similar Medicare Providers

1922936079 — EMILY DWYER
Practice Location Address:
3821 SOUTHERN AVE
SHREVEPORT, LA
71106-1033
Practice Phone: 318-946-8157
Practice Fax:
1437413192 — THERESE DIANE SCHAFFNER LAC, LPC-S, NCC
Practice Location Address:
3821 SOUTHERN AVE
SHREVEPORT, LA
71106-1033
Practice Phone: 318-946-8157
Practice Fax: 318-216-5868
1962865279 — JEREMY LINDSAY
Practice Location Address:
3821 SOUTHERN AVE
SHREVEPORT, LA
71106-1033
Practice Phone: 318-946-8157
Practice Fax:
1952815458 — KELLYE JEAN LEWIS MA, LPC, NCC
Practice Location Address:
3821 SOUTHERN AVE
SHREVEPORT, LA
71106-1033
Practice Phone: 318-946-8157
Practice Fax:
1093204554 — ANNA-KATRINA RUPEL LMHC, LPCC
Practice Location Address:
3821 SOUTHERN AVE
SHREVEPORT, LA
71106-1033
Practice Phone: 318-946-8157
Practice Fax:
1780153270 — MELISSA TROY CIT
Practice Location Address:
3821 SOUTHERN AVE
SHREVEPORT, LA
71106-1033
Practice Phone: 318-946-8157
Practice Fax: 318-216-5868

Directions to “ KATHRYN COSTELLO LPC” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.