Basic Information
Provider Information
NPI: 1093969354
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHARP
FirstName: CATHERINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW, LCSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 RUSKIN DR
Address2:  
City: COLORADO SPRINGS
State: CO
PostalCode: 809102522
CountryCode: US
TelephoneNumber: 7195726150
FaxNumber:  
Practice Location
Address1: 115 PARKSIDE DR
Address2:  
City: COLORADO SPRINGS
State: CO
PostalCode: 809103130
CountryCode: US
TelephoneNumber: 7195726340
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/12/2008
LastUpdateDate: 03/11/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 
1041C0700XCSW.00000235COY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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