Healthcare Provider Details

I. General information

NPI: 1376305508
Provider Name (Legal Business Name): KATHERINE GRIM LPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

IV. Provider business mailing address

1290 CHAMBERS RD
AURORA CO
80011-7117
US

V. Phone/Fax

Practice location:
  • Phone: 303-642-5715
  • Fax:
Mailing address:
  • Phone: 303-617-2300
  • Fax: 303-617-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0019743
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACD.0002175
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: