Provider Demographics
NPI:1093049181
Name:SPOONER, KATHERINE Q (MSSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:Q
Last Name:SPOONER
Suffix:
Gender:F
Credentials:MSSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7116
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-0116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6363 W 120TH AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-0300
Practice Address - Country:US
Practice Address - Phone:618-531-4161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical