Provider Demographics
NPI:1558068775
Name:LARSEN, KATHERINE (LPCC)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LARSEN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17972 E 107TH AVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-4055
Mailing Address - Country:US
Mailing Address - Phone:720-427-9279
Mailing Address - Fax:
Practice Address - Street 1:14143 DENVER WEST PKWY
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80401-3266
Practice Address - Country:US
Practice Address - Phone:720-594-5556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health