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NPI Code Detail

MEDICARE: KATHLEEN RUTH HUISINGA LCSW

MEDICARE: KATHLEEN RUTH HUISINGA LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW.09927850CO

General Provider Information

NPI Number : 1548760598
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN RUTH HUISINGA LCSW
Provider Business Mailing Address
First Line : 1650 S TOPAZ WAY
Second Line :
City : MERIDIAN
State : ID
Zip : 83642-4474
Country : US
Telephone Number : 208-605-7070
Fax Number :
Provider Business Practice Location Address
First Line : 4565 KENDALL PKWY
Second Line :
City : LOVELAND
State : CO
Zip : 80538-9268
Country : US
Telephone Number : 970-410-8228
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2018
Last Update Date : 02/13/2024

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