Basic Information
| Provider Information | |||||||||
| NPI: | 1396206199 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUMAN | ||||||||
| FirstName: | KATIE | ||||||||
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| Credential: | LAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 JUMPING BROOK RD. | ||||||||
| Address2: | BLDG 5, STE 201 | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326434372 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1945 STATE ROUTE 33 | ||||||||
| Address2: | |||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077534859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7327762325 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2019 | ||||||||
| LastUpdateDate: | 03/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 37AC00328300 | NJ | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.