Provider Demographics
NPI:1275181430
Name:MIEREK, KATHERINE ELIZABETH (LCMHC/LCAS)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:ELIZABETH
Last Name:MIEREK
Suffix:
Gender:F
Credentials:LCMHC/LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CENTER DR STE G314
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8625
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:255 DOGWOOD RD
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-8448
Practice Address - Country:US
Practice Address - Phone:828-263-4195
Practice Address - Fax:828-544-1201
Is Sole Proprietor?:No
Enumeration Date:2019-08-30
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15301101YM0800X, 101YM0800X
NCLCAS-25846101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)