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NPI Code Detail

MEDICARE: KATHERINE MACDOUGALL MSW

MEDICARE: KATHERINE MACDOUGALL MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorACD.0002731CO
21041C0700XClinical Social WorkerCSW.09924322CO

General Provider Information

NPI Number : 1003165978
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MACDOUGALL MSW
Provider Business Mailing Address
First Line : 4856 INNOVATION DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5539
Country : US
Telephone Number : 970-494-4200
Fax Number : 844-270-1824
Provider Business Practice Location Address
First Line : 700 CENTRE AVE
Second Line :
City : FORT COLLINS
State : CO
Zip : 80526-1842
Country : US
Telephone Number : 970-494-4200
Fax Number : 844-270-1824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2012
Last Update Date : 07/29/2025

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