Provider Demographics
NPI:1477091700
Name:RICHARDSON, KATIE ANNE
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:ANNE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 E BELLEVIEW AVE STE 312C
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2880
Mailing Address - Country:US
Mailing Address - Phone:720-256-4890
Mailing Address - Fax:720-489-3776
Practice Address - Street 1:8200 E BELLEVIEW AVE STE 312C
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2880
Practice Address - Country:US
Practice Address - Phone:720-256-4890
Practice Address - Fax:720-489-3776
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00002025104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker