Healthcare Provider Details

I. General information

NPI: 1730824715
Provider Name (Legal Business Name): KATHARINE HOTVEDT LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 05/03/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S WADSWORTH BLVD
LAKEWOOD CO
80226-3111
US

IV. Provider business mailing address

12954 W ILIFF AVE
LAKEWOOD CO
80228-4336
US

V. Phone/Fax

Practice location:
  • Phone: 303-954-4052
  • Fax:
Mailing address:
  • Phone: 303-954-4052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00017488
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: