Provider Demographics
NPI:1417414616
Name:KHAN, NATALIE KRISTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:KRISTINE
Last Name:KHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9283 TWENTY MILE RD UNIT 1102
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-6086
Mailing Address - Country:US
Mailing Address - Phone:763-957-2152
Mailing Address - Fax:
Practice Address - Street 1:9283 TWENTY MILE RD UNIT 1102
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-6086
Practice Address - Country:US
Practice Address - Phone:763-957-2152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-23
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099249571041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical