Healthcare Provider Details

I. General information

NPI: 1780046292
Provider Name (Legal Business Name): KATHRINE COLLINS ANDERSON MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 E RAILROAD AVE STE 500
FORT MORGAN CO
80701-3144
US

IV. Provider business mailing address

324 E RAILROAD AVE STE 500
FORT MORGAN CO
80701-3144
US

V. Phone/Fax

Practice location:
  • Phone: 970-673-0831
  • Fax:
Mailing address:
  • Phone: 970-673-0831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC0012589
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: