Basic Information
| Provider Information | |||||||||
| NPI: | 1770536922 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SMITH | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MA, LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 744 HORIZON CT STE 220 | ||||||||
| Address2: | |||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815063939 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9703141912 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 744 HORIZON CT | ||||||||
| Address2: | |||||||||
| City: | GRAND JUNCTION | ||||||||
| State: | CO | ||||||||
| PostalCode: | 815063921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9702453270 | ||||||||
| FaxNumber: | 9702456660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 03/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 3669 | CO | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.