Provider Demographics
NPI:1437344975
Name:PRESTON, KATHRYN L (MSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:PRESTON
Suffix:
Gender:F
Credentials:MSW
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 51237
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80949-1237
Mailing Address - Country:US
Mailing Address - Phone:719-593-1608
Mailing Address - Fax:
Practice Address - Street 1:5140 GOLDEN HILLS CT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-8156
Practice Address - Country:US
Practice Address - Phone:719-321-7905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9891871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical