Provider Demographics
NPI:1376046383
Name:SUTTON, KATHLEEN J (MA, ATR, LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:J
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MA, ATR, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5145 W 11TH ST APT 814
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2167
Mailing Address - Country:US
Mailing Address - Phone:970-739-5522
Mailing Address - Fax:
Practice Address - Street 1:5145 W 11TH ST APT 814
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2167
Practice Address - Country:US
Practice Address - Phone:970-739-5522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014421101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health