Healthcare Provider Details

I. General information

NPI: 1962087213
Provider Name (Legal Business Name): KATHERINE BURRALL MSW, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2021
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N BOULEVARD ST
GUNNISON CO
81230-2825
US

IV. Provider business mailing address

800 N BOULEVARD ST
GUNNISON CO
81230-2825
US

V. Phone/Fax

Practice location:
  • Phone: 970-641-7750
  • Fax:
Mailing address:
  • Phone: 970-641-7750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-160125
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number0009927148
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: