Organization
PEACE PSYCHOLOGY CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATE STARK PHD (MANAGER AND LICENSED PSYCHOLOGIST)
(817) 917-7348
Entity
Organization
Contact information
Practice address
1723 E SOUTHLAKE BLVD STE 200, SOUTHLAKE, TX 76092-6445
(817) 917-7348
Mailing address
1723 E SOUTHLAKE BLVD STE 200, SOUTHLAKE, TX 76092-6445
(682) 292-7012
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
103TM1800X
Intellectual & Developmental Disabilities Psychologist
—
—
103TS0200X
School Psychologist
—
—
Other
Enumeration date
03/12/2021
Last updated
09/03/2022
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