Healthcare Provider Details

I. General information

NPI: 1073449625
Provider Name (Legal Business Name): KATHERINE ERSTAD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 KIMBARK ST STE 200
LONGMONT CO
80501-5585
US

IV. Provider business mailing address

500 KIMBARK ST STE 200
LONGMONT CO
80501-5585
US

V. Phone/Fax

Practice location:
  • Phone: 303-651-1515
  • Fax:
Mailing address:
  • Phone: 303-651-1515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWC.0000002171
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: