MEDICARE: NOSTRUM NON-PROFIT

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1376130559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOSTRUM NON-PROFIT

Provider Business Mailing Address
First Line	:	3570 E 12TH AVE STE 107
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3431
Country	:	US
Telephone Number	:	720-361-8799
Fax Number	:

Provider Business Practice Location Address
First Line	:	3570 E 12TH AVE STE 107
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80206-3431
Country	:	US
Telephone Number	:	720-361-8799
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	DR. KATHERINE FERRARA
Credential	:	LCSW
Telephone Number	:	720-361-8799

Provider Enumeration Date	:	12/22/2020
Last Update Date	:	12/22/2020

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Directions to “NOSTRUM NON-PROFIT ” Practice Location

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