Provider Demographics
NPI:1538306865
Name:STCLAIR, KATHY LYNN (LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:LYNN
Last Name:STCLAIR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 WHITEHALL DR
Mailing Address - Street 2:UNIT B
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-7980
Mailing Address - Country:US
Mailing Address - Phone:303-772-5797
Mailing Address - Fax:
Practice Address - Street 1:1361 FRANCIS ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-2576
Practice Address - Country:US
Practice Address - Phone:303-485-0339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO767101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional