Healthcare Provider Details

I. General information

NPI: 1194441022
Provider Name (Legal Business Name): CONNOR DE CATRON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CONNOR CATRON

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11308 FOWLER DR
NORTHGLENN CO
80233-3249
US

IV. Provider business mailing address

11308 FOWLER DR
NORTHGLENN CO
80233-3249
US

V. Phone/Fax

Practice location:
  • Phone: 720-663-8668
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSW.09933443
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: