Healthcare Provider Details

I. General information

NPI: 1194942730
Provider Name (Legal Business Name): KATHERINE BOOZ WARD L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3405 PENROSE PL STE 106
BOULDER CO
80301-1819
US

IV. Provider business mailing address

3405 PENROSE PL STE 106
BOULDER CO
80301-1819
US

V. Phone/Fax

Practice location:
  • Phone: 303-999-1364
  • Fax:
Mailing address:
  • Phone: 303-999-1364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: