Provider Demographics
NPI:1386044881
Name:MCDONALD, KATHERINE (MA, LPC, LAC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MA, LPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3080 S KRAMERIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-7033
Mailing Address - Country:US
Mailing Address - Phone:720-923-2122
Mailing Address - Fax:
Practice Address - Street 1:3080 S KRAMERIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-7033
Practice Address - Country:US
Practice Address - Phone:720-923-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-03
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0002010101YA0400X
CONLC.0104689101YM0800X
COLPC.0014444101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO624855Medicaid