Healthcare Provider Details

I. General information

NPI: 1164890554
Provider Name (Legal Business Name): ANN CATHERINE ANDERSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE ANDERSON SHOOTER LCSW

II. Dates (important events)

Enumeration Date: 09/02/2015
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S NEVADA AVE
MONTROSE CO
81401-4273
US

IV. Provider business mailing address

300 S NEVADA AVE
MONTROSE CO
81401-4273
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-7751
  • Fax: 970-249-5029
Mailing address:
  • Phone: 970-249-7751
  • Fax: 970-249-5029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number09925757
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCW013425
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCW013425
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCW013425
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberCW013425
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: