MEDICARE: STACEY LEE BLANKENSHIP CAT

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	ACA.0008517	CO
2	101Y00000X	Counselor		CO

General Provider Information

NPI Number	:	1447181078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY LEE BLANKENSHIP CAT

Provider Business Mailing Address
First Line	:	3031 S IRVING ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80236-2305
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2850 MCCLELLAND DR STE 3200
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2572
Country	:	US
Telephone Number	:	970-235-0011
Fax Number	:

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

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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