Provider Demographics
NPI:1467599662
Name:THOMPSON, CATHARINE SARA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CATHARINE
Middle Name:SARA
Last Name:THOMPSON
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 1:665 WILDROSE WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1078
Mailing Address - Country:US
Mailing Address - Phone:303-604-6160
Mailing Address - Fax:
Practice Address - Street 1:3460 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-1824
Practice Address - Country:US
Practice Address - Phone:303-441-1509
Practice Address - Fax:303-441-1517
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9911201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC22579Medicaid