Southlake Child and Family Therapy

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

SOUTHLAKE CHILD AND FAMILY THERAPY

Practice address

2141 Kirkwood Blvd Ste 130
Southlake, TX 76092-1464

Phone

(817) 266-8676

NPI assigned

Jan 4, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Katharine Anne Ottone Davis, PHD, LPC

Title

Owner

Phone

(817) 266-8676

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Katharine Ottone, PHD, LPC

  • Counselor
  • Southlake, TX
  • NPI 1922476597
  NPD
• Robin Gildenzopf, MED, LCDC, LPC

  • Professional Counselor
  • Bedford, TX
  • NPI 1184337230
  NPD (past)

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1689387797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 BERKELEY PL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101209",
            "telephone_number": "817-266-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 KIRKWOOD BLVD STE 130",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921464",
            "telephone_number": "817-266-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHLAKE CHILD AND FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "OTTONE DAVIS",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-266-8676",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sohn Dental, PC
• Solar Health, P.a.
• Luke Paine Sorrell, M.D.
• Rodney Wayne Sosa, MD
• Laverna Soucie
• Southlake Childrens Sleep Center, LTD
• Southlake Chiropractic Clinic
• Southlake Dental Care, PA
• Southlake Diagnostics Inc
• Southlake Diagnostics Inc

• Professional Counselor in Southlake, TX
• Providers in Southlake, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.