MEDICARE: KATHRYN MARQUARD CSW

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
1	1041C0700X	Clinical Social Worker	CSW.09931587	CO
2	1041C0700X	Clinical Social Worker	LSW.0009924288	CO

General Provider Information

NPI Number	:	1194430090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN MARQUARD CSW

Provider Business Mailing Address
First Line	:	357 ALBION WAY UNIT B4
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-3275
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	357 ALBION WAY UNIT B4
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-3275
Country	:	US
Telephone Number	:	970-682-4140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2023
Last Update Date	:	11/08/2025

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