MEDICARE: MS. KATHERINE ELIZABETH SCHOMP LCSW

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	CSW00991113	CO

General Provider Information

NPI Number	:	1245696970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHERINE ELIZABETH SCHOMP LCSW

Provider Business Mailing Address
First Line	:	PO BOX 21150
Second Line	:
City	:	BOULDER
State	:	CO
Zip	:	80308-4150
Country	:	US
Telephone Number	:	303-807-0562
Fax Number	:	720-328-4369

Provider Business Practice Location Address
First Line	:	1776 S JACKSON ST STE 810
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-3807
Country	:	US
Telephone Number	:	303-807-0562
Fax Number	:	720-328-4369

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

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	05/06/2022

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