Individual
KATHRYN COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3821 SOUTHERN AVE, SHREVEPORT, LA 71106-1033
(318) 946-8157
Mailing address
3800 FERNRIDGE DR, LONGVIEW, TX 75605-2516
(318) 805-2132
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5571
LA
101YP2500X
Professional Counselor
Primary
5571
LA
Other
Enumeration date
06/23/2017
Last updated
09/24/2025
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