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Individual
MRS. KATHLEEN THERESA GLEASON
Active
Individual
MRS. KATHLEEN THERESA GLEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC, DCFC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
12497
TX
101YP2500X
Professional Counselor
Primary
12497
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12497
TEXAS STATE BOARD OF EXAM
TX
01
—
217
TX. STATE BOARD OF EXAMIN
TX
01
—
31866
NATIONAL BOARD FOR CERTIF
TX
01
—
3791LC
BLUECROSSBLUESHIELDINSURA
TX
Enumeration date
11/27/2007
Last updated
02/22/2008
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