Individual provider Active NPI

Katherine Victoria Funk, LMFT

  • Mental Health Counselor
  • The Woodlands, TX
National Provider Identifier
1063010601
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
25511 Budde Rd Ste Officef
The Woodlands, TX 77380-2080
Phone
(518) 302-1879
NPI assigned
Oct 15, 2020
Last updated
Oct 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

25511 Budde Rd Ste Officef
The Woodlands, TX 77380-2080

Mailing address

25511 Budde Rd Ste 3601
The Woodlands, TX 77380-4065

Other identifiers 1

IdentifierTypeStateIssuer
84-3905991OtherTXFEDERAL GOVERNMENT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1063010601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25511 BUDDE RD STE 3601",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773804065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25511 BUDDE RD STE OFFICEF",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802080",
            "telephone_number": "518-302-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "KATHERINE",
        "middle_name": "VICTORIA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL GOVERNMENT",
            "identifier": "84-3905991",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.