Healthcare Provider Details

I. General information

NPI: 1922826312
Provider Name (Legal Business Name): KATRINA KLINE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 S HOLMAN WAY APT 1B
GOLDEN CO
80401-5130
US

IV. Provider business mailing address

36 S HOLMAN WAY APT 1B
GOLDEN CO
80401-5130
US

V. Phone/Fax

Practice location:
  • Phone: 612-600-6799
  • Fax:
Mailing address:
  • Phone: 612-600-6799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09933481
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: