Healthcare Provider Details

I. General information

NPI: 1174934061
Provider Name (Legal Business Name): KATHERINE M PRUITT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 E 1ST AVE SUITE 200
DENVER CO
80230-7204
US

IV. Provider business mailing address

7351 E LOWRY BLVD SUITE 200
DENVER CO
80230-6082
US

V. Phone/Fax

Practice location:
  • Phone: 303-731-8926
  • Fax: 303-367-2576
Mailing address:
  • Phone: 303-825-8589
  • Fax: 720-214-4609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11838
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: